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一种新型的7天长期饮食剥夺方案在重新喂养3至6个月后可改善谷丙转氨酶和尿酸水平,显示出治疗潜力。

A Novel 7-Days Prolonged Dietary Deprivation Regimen Improves ALT and UA After 3-6 Months Refeeding, Indicating Therapeutic Potential.

作者信息

Wang Xiaoxue, Li Zhihui, Zhao Yancong, Yu Yaying, Xue Yanyan, Niu Chenguang, Wei Qiannan, Zhao Zhijun, Cai Shangyuan, Xu Hongxia, Zhang Chenlu, Zhang Chenggang, Lee Garrick D

机构信息

The First Affiliated Hospital of Henan University, Kaifeng, China.

Institute on Aging and Disease of Henan University, Kaifeng, China.

出版信息

Front Nutr. 2020 May 6;7:50. doi: 10.3389/fnut.2020.00050. eCollection 2020.

Abstract

The aim of this study was to evaluate a total fasting regimen assisted by a novel prebiotic, Flexible Abrosia (FA), in more than 7 days of continual dietary deprivation (7D-CDD). Our analysis included basic physical examinations, bioelectrical impedance analysis, and clinical lab and ELISA analysis in normal volunteers. Seven healthy subjects with normal body weight participated in 7D-CDD with the assistance of a specially designed probiotic. Individuals were assigned to take FA (113.4 KJ/10 g) at each mealtime to avoid possible injuries to intestinal flora and smooth the hunger sensation. During 7D-CDD, the subjects were advised to avoid any food intake, especially carbohydrates, except for drinking plentiful amounts of water. The examination samples were collected before CDD as self-control, at 7 days fasting, and after 714 days of refeeding. Three subjects were also tested after 6-m refeeding. The FA-CDD regimen significantly decreased suffering from starvation, with tolerable hunger sensations during the treatment. With the addition of daily mineral electrolytes, the subjects not only passed through the entire 7D-CDD regimen but also succeed in 1213 days total fasting in two subjects. There was a significant reduction in blood glucose, insulin, and high-density lipoprotein levels during fasting, and the blood concentrations of uric acid (UA), alanine aminotransferase (ALT), and creatine kinase (CK) were increased. However, after more than 2 months of refeeding, the disease markers ALT, GOT, and CK either remained stable or were slightly downregulated compared to their initial D0 control level. Our experiment has supplied the first positive evidence that, with the assistance of a daily nutritional supply of around 100 kcal total calories to their intestinal flora, human subjects were able to tolerate hunger sensations. We have found that, although 7D-CDD induced increases in UA, CK, and transferases during fasting, refeeding led the markers to become either down-regulated or unchanged compared to their initial levels. This phenomenon was further confirmed in longer-term (6 m) recovery. Our results failed to support the hypothesis that fasting induced liver damage, since ALT, GOT, and CK remained low after longer-term refeeding. Our findings indicate that the 7D-CDD regimen might be practical and that it might be valuable to design larger clinical fasting trials for improvement of health strategy-targeting in metabolic disorders.

摘要

本研究的目的是评估一种新型益生元——灵活阿布洛西亚(FA)辅助的全禁食方案,用于超过7天的持续饮食剥夺(7D-CDD)。我们的分析包括对正常志愿者进行基本身体检查、生物电阻抗分析以及临床实验室和酶联免疫吸附测定(ELISA)分析。七名体重正常的健康受试者在一种特别设计的益生菌辅助下参与了7D-CDD。受试者被安排在每餐时服用FA(113.4千焦/10克),以避免对肠道菌群造成可能的损伤并缓解饥饿感。在7D-CDD期间,建议受试者避免任何食物摄入,尤其是碳水化合物,除了饮用大量的水。检查样本在CDD前作为自身对照采集,在禁食7天时采集,以及在重新进食7至14天后采集。三名受试者在重新进食6个月后也进行了测试。FA-CDD方案显著减轻了饥饿感,治疗期间饥饿感可耐受。通过补充每日矿物质电解质,受试者不仅完成了整个7D-CDD方案,而且两名受试者成功进行了12至13天的全禁食。禁食期间血糖、胰岛素和高密度脂蛋白水平显著降低,而尿酸(UA)、丙氨酸转氨酶(ALT)和肌酸激酶(CK)的血浓度升高。然而,在重新进食两个多月后,与初始D0对照水平相比,疾病标志物ALT、谷草转氨酶(GOT)和CK要么保持稳定,要么略有下调。我们的实验提供了首个积极证据,即通过每天向肠道菌群提供约100千卡总热量的营养供应,人类受试者能够耐受饥饿感。我们发现,尽管7D-CDD在禁食期间导致UA、CK和转氨酶升高,但重新进食导致这些标志物与初始水平相比下调或保持不变。这一现象在长期(6个月)恢复中得到了进一步证实。我们的结果未能支持禁食会导致肝损伤的假设,因为长期重新进食后ALT、GOT和CK仍保持在较低水平。我们的研究结果表明,7D-CDD方案可能是可行的,并且设计更大规模的临床禁食试验以改善针对代谢紊乱的健康策略可能是有价值的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2159/7218643/a2ef38370eb5/fnut-07-00050-g0001.jpg

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