Buchinger Wilhelmi Clinic, 88662 Überlingen, Germany.
Clinic St. Katharinental, Department of Rheumatology, 8253 Diessenhofen, Switzerland.
Nutrients. 2019 Oct 30;11(11):2601. doi: 10.3390/nu11112601.
This prospective observational trial investigated effects and safety of periodic fasting in subjects with and without type 2 diabetes mellitus (T2DM). The primary end point was set as the change of fatty liver index (FLI) as a surrogate parameter of non-alcoholic fatty liver disease (NAFLD). Six-hundred and ninety-seven subjects (38 with T2DM) were enrolled. A baseline FLI ≥ 60 (the threshold for fatty liver) was found in 264 subjects (37.9%). The mean duration of fasting was 8.5 ± 4.0 days (range 6-38). FLI decreased significantly (-14.02 ± 11.67; < 0.0001), with a larger effect in individuals with T2DM (-19.15 ± 11.0; < 0.0001; = 0.002 compared to non-diabetic subjects). Body mass index (BMI) decreased by -1.51 ± 0.82 kg/m, and 49.9% of the subjects lost ≥5% body weight. After fasting, nearly half of the 264 subjects with FLI ≥ 60 (highest risk category) shifted to a lower category. The improvement of FLI correlated with the number of fasting days (r = -0.20, < 0.0001) and with the magnitude of BMI reduction (r = 0.14, = 0.0001). Periodic fasting with concomitant weight reduction leads to significant rapid improvement of FLI in subjects with and without T2DM.
这项前瞻性观察性试验研究了周期性禁食对 2 型糖尿病（T2DM）患者和非 2 型糖尿病患者的影响和安全性。主要终点设定为非酒精性脂肪性肝病（NAFLD）替代参数——脂肪肝指数（FLI）的变化。共纳入 697 名受试者（38 名患有 T2DM）。264 名受试者（37.9%）基线 FLI≥60（脂肪肝阈值）。禁食平均持续时间为 8.5±4.0 天（范围 6-38 天）。FLI 显著下降（-14.02±11.67；<0.0001），T2DM 患者的下降幅度更大（-19.15±11.0；<0.0001；与非糖尿病患者相比，=0.002）。体重指数（BMI）下降 1.51±0.82kg/m，49.9%的受试者体重减轻≥5%。禁食后，264 名 FLI≥60（风险最高类别）的受试者中近一半转为较低类别。FLI 的改善与禁食天数（r=-0.20，<0.0001）和 BMI 降低幅度（r=0.14，=0.0001）相关。周期性禁食和体重减轻可使 T2DM 患者和非 T2DM 患者的 FLI 显著迅速改善。
