Division of Endocrinology and Diabetes, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
SC CTSI, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
Nutr Diabetes. 2019 Jul 15;9(1):20. doi: 10.1038/s41387-019-0088-7.
Delivery of nutrients directly to the small intestine, either via enteral feeding tube or by gastric bypass surgery, is associated with increased levels of appetite-suppressing and glucoregulatory hormones, including GLP-1, and reduced appetite. Achieving these changes non-invasively using formulated foods may be of therapeutic benefit in individuals with obesity and related comorbidities. The aim of this pilot study was to determine the effect of a single dose of a novel delayed-release nutrient (DRN) on glucose, GLP-1, c-peptide, insulin, and appetite in adults with obesity and type 2 diabetes.
We formulated an all-natural, generally recognized as safe ('GRAS") DRN and conducted a randomized prospective crossover trial. Nineteen adults with obesity and type 2 diabetes underwent paired 3-h meal tolerance tests (MTT) in randomized order 1-4 weeks apart. Subjects ingested a single dose of DRN and the same nutrients as unformulated powders (UN).
For DRN compared with UN, the maximal concentration (Cmax) was significantly lower for glucose, c-peptide, and insulin, and the time of maximal concentration (Tmax) was significantly delayed. While Tmax for GLP-1 was also significantly delayed following DRN compared with UN (45 min later; p = 0.26), Cmax did not differ significantly. GLP-1 rose significantly during the last 90 min of the 3-h MTT (β = 0.16 pg/mL/min, p = 0.025), while following UN it decreased (β = -0.21 pg/mL/min, p = 0.0026) (p difference = 0.0003). There were minimal differences in seven measures of appetite and adverse symptoms between DRN and UN.
We conclude that nutrient can be formulated using all-natural ingredients to induce a delayed rise in GLP-1. Further testing is needed to determine the amount and site of nutrient release, when maximum GLP-1 levels occur, and if modification of the formulation specifications and dose are associated with appetite and glucose control.
将营养物质直接输送到小肠，无论是通过肠内喂养管还是通过胃旁路手术，都会导致食欲抑制和糖调节激素（包括 GLP-1）水平升高，从而降低食欲。使用配方食品实现这些变化无需进行侵入性操作，可能对肥胖症和相关合并症患者具有治疗益处。本研究旨在确定单次给予新型缓释营养素（DRN）对肥胖症和 2 型糖尿病成人的葡萄糖、GLP-1、C 肽、胰岛素和食欲的影响。
我们开发了一种全天然、公认安全（“GRAS”）的 DRN，并进行了一项随机前瞻性交叉试验。19 名肥胖症和 2 型糖尿病患者在 1-4 周的间隔内，以随机顺序进行了两次 3 小时的膳食耐受性试验（MTT）。受试者单次摄入 DRN 和未成型粉末（UN）的相同营养物质。
与 UN 相比，DRN 的葡萄糖、C 肽和胰岛素的最大浓度（Cmax）显著降低，达峰时间（Tmax）显著延迟。虽然与 UN 相比，DRN 后 GLP-1 的 Tmax 也显著延迟（45 分钟后；p=0.26），但 Cmax 无显著差异。在 3 小时 MTT 的最后 90 分钟内，GLP-1 显著升高（β=0.16 pg/mL/min，p=0.025），而 UN 则下降（β=-0.21 pg/mL/min，p=0.0026）（p 差值=0.0003）。DRN 和 UN 之间的七种食欲和不良反应指标几乎没有差异。
我们得出结论，营养物质可以使用全天然成分进行配方，以诱导 GLP-1 的延迟升高。需要进一步测试以确定营养素释放的量和部位、最大 GLP-1 水平出现的时间，以及配方规格和剂量的改变是否与食欲和血糖控制相关。
Zotero 插件
