Wikarek Tomasz, Kocełak Piotr, Owczarek Aleksander J, Chudek Jerzy, Olszanecka-Glinianowicz Magdalena
Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, Katowice, Poland.
Department of Gynecology and Obstetrics, Medical Faculty in Katowice, The Medical University of Silesia, Katowice, Poland.
Int J Endocrinol. 2020 Apr 30;2020:4603682. doi: 10.1155/2020/4603682. eCollection 2020.
The aim of the study was to assess the effect of dietary macronutrients on circulating glucagon and insulin levels in obese and normal-weight women. Potentially, the impaired release of glucagon may proceed abnormal glucose metabolism in obese patients ahead of overt diabetes. In 20 insulin-sensitive women (11 obese and 9 normal-weight), plasma concentrations of insulin and glucagon levels were assessed before and after 3 different macronutrient test meals. AUC insulin in the obese group was increased after protein and carbohydrates compared to fatty test meal consumption (3981 ± 2171 and 4869 ± 2784 vs. 2349 ± 1004 IUh/m, < 0.05, respectively), but without a difference between protein and carbohydrates ingestion. However, in the normal-weight group, AUC insulin was increased after carbohydrates compared to fatty test meal ingestion (3929 ± 1719 vs. 2231 ± 509 IUh/ml, < 0.05) and similar after carbohydrate and protein as well as after fatty and protein test meals (3929 ± 1719 vs. 2231 ± 509 vs. 3046 ± 1406 IUh/ml, respectively). However, AUC insulin was significantly increased in obese compared to normal-weight women only after carbohydrate test meal ingestion (4869 ± 2784 vs. 3929 ± 1719 IUh/ml, < 0.05). AUC glucagon was similar after carbohydrate, protein, and fatty test meals ingestion in obese and normal-weight women (921 ± 356 vs. 957 ± 368 vs. 926 ± 262 ngh/ml and 1196 ± 14 vs. 1360 ± 662 vs. 1792 ± 1176 ngh/ml, respectively). AUC glucagon was significantly lower in obese than normal-weight women after a fatty meal (926 ± 262 vs. 1792 ± 1176 ngh/ml, < 0.01). Postprandial glucagon secretion is not related to the macronutrient composition of the meal in normal-weight women since postprandial glucagon concentrations were stable and did not change after carbohydrate, protein, and fatty test meals. Lower glucagon secretion was observed in obese subjects after fatty meal consumption when compared to normal-weight subjects. Postprandial insulin profile was significantly higher after carbohydrate than fatty test meal intake in the obese group and did not differ between obese and normal-weight groups after carbohydrate, protein, and fatty test meals consumption. Impaired glucagon secretion after fatty meat suggests early pancreatic alpha-cell dysfunction, after a carbohydrate meal is a compensatory mechanism.
本研究的目的是评估膳食常量营养素对肥胖和正常体重女性循环中胰高血糖素和胰岛素水平的影响。潜在地，胰高血糖素释放受损可能在肥胖患者明显患糖尿病之前就导致葡萄糖代谢异常。在20名胰岛素敏感的女性（11名肥胖和9名正常体重）中，在3种不同的常量营养素测试餐后，评估胰岛素和胰高血糖素水平的血浆浓度。与食用脂肪测试餐相比，肥胖组在摄入蛋白质和碳水化合物后胰岛素曲线下面积（AUC）增加（分别为3981±2171和4869±2784 vs. 2349±1004 IUh/m，P<0.05），但蛋白质和碳水化合物摄入之间无差异。然而，在正常体重组中，与食用脂肪测试餐相比，摄入碳水化合物后胰岛素AUC增加（3929±1719 vs. 2231±509 IUh/ml，P<0.05），碳水化合物和蛋白质后以及脂肪和蛋白质测试餐后相似（分别为3929±1719 vs. 2231±509 vs. 3046±1406 IUh/ml）。然而，仅在摄入碳水化合物测试餐后，肥胖女性的胰岛素AUC显著高于正常体重女性（4869±2784 vs. 3929±1719 IUh/ml，P<0.05）。肥胖和正常体重女性在摄入碳水化合物、蛋白质和脂肪测试餐后胰高血糖素AUC相似（分别为921±356 vs. 957±368 vs. 926±262 ngh/ml和1196±14 vs. 1360±662 vs. 1792±1176 ngh/ml）。肥胖女性在食用脂肪餐后胰高血糖素AUC显著低于正常体重女性（926±262 vs. 1792±1176 ngh/ml，P<0.01）。在正常体重女性中，餐后胰高血糖素分泌与餐食的常量营养素组成无关，因为餐后胰高血糖素浓度稳定，在碳水化合物、蛋白质和脂肪测试餐后没有变化。与正常体重受试者相比，肥胖受试者在食用脂肪餐后胰高血糖素分泌较低。肥胖组中碳水化合物测试餐后的餐后胰岛素曲线显著高于脂肪测试餐摄入后，在摄入碳水化合物、蛋白质和脂肪测试餐后，肥胖组和正常体重组之间没有差异。食用高脂肪肉类后胰高血糖素分泌受损表明早期胰腺α细胞功能障碍，食用碳水化合物餐后是一种代偿机制。
