Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands.
Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands.
Nutrients. 2020 Sep 29;12(10):2979. doi: 10.3390/nu12102979.
(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and β-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, = 42) and without MIR (no-MIR, = 40). (3) Results: Only in patients from the MIR subgroup that received protein drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VOpeak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.
(1) 背景：最近的研究表明，2 型糖尿病患者的亚型可能根据其器官特异性胰岛素抵抗（IR）对生活方式干预的反应不同。(2) 方法：123 名 2 型糖尿病患者被随机分为 13 周的生活方式干预组，分别接受富含蛋白质的饮料（蛋白质+）或等热量对照饮料（对照）。在干预前后，收集人体测量和生理数据。口服葡萄糖耐量试验用于计算代表器官胰岛素抵抗（肌肉、肝脏和脂肪组织）和β细胞功能的指数。在 82 名符合研究方案的受试者（意向性治疗）中，我们回顾性地检查了肌肉 IR（MIR，n=42）和无 MIR（无 MIR，n=40）患者的干预效果。(3) 结果：只有在接受蛋白质饮料的 MIR 亚组患者中，空腹血糖和胰岛素、全身、肝脏和脂肪 IR 以及四肢骨骼肌质量与对照组相比有所改善。在两个亚组中，生活方式干预都改善了体重和脂肪量。此外，MIR 亚组的收缩压降低，VOpeak 增加，无 MIR 亚组的 2 小时血糖浓度降低。(4) 结论：在联合生活方式干预中添加富含蛋白质的饮料似乎对增加肥胖、老年 2 型糖尿病肌肉 IR 患者的肌肉质量和改善胰岛素抵抗特别有效。
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