一种基于血清脂肪酸和氨基酸的新开发的饱和脂肪过量摄入指标及其与2型糖尿病发病率的关联：来自两项随机对照喂养试验和一项前瞻性研究的证据
A Newly Developed Indicator of Overeating Saturated Fat Based on Serum Fatty Acids and Amino Acids and Its Association With Incidence of Type 2 Diabetes: Evidence From Two Randomized Controlled Feeding Trials and a Prospective Study.
作者信息
Wei Wei, Zi Tianqi, Yang Ruiming, Xu Jiaxu, Chen Yunyan, Jiang XiTao, Chu Xia, Yang Xue, Jiang Wenbo
机构信息
Department of Nutrition and Food Hygiene, National Key Discipline, School of Public Health, Harbin Medical University, Harbin, China.
Key Laboratory of Cardiovascular Research, Department of Pharmacology, College of Pharmacy, Ministry of Education, Harbin Medical University, Harbin, China.
出版信息
Front Nutr. 2022 Jun 14;9:897375. doi: 10.3389/fnut.2022.897375. eCollection 2022.
OBJECTIVE
Hyper-caloric intake of saturated fatty acids (SFAs) is common in modern societies, probably contributing to the epidemic of type 2 diabetes mellitus (T2DM). This study conducted two randomized controlled trials (RCTs) for developing a new indicator that can assess the nutritional status and examined its association with incidence of T2DM.
METHODS
In RCT 1, healthy participants were randomly assigned into three groups, namely, control group ( = 40), overfeeding group 1 (100 g butter per day, = 37), and overfeeding group 2 (120 g butter per day, = 37). In RCT 2, healthy subjects were randomly assigned into two groups, namely, control group ( = 52) and high-fat group (300-extra kcal/day from diet that was designed by high-fat diet, = 58). In the prospective cohort, 4,057 participants aged 20-74 years were enrolled and followed up over 5.3 years. Serum profiles of fatty acids and amino acids were measured.
RESULTS
In RCT 1, serum fatty acids, including C14:0 and C18:0, increased, whereas C18:2, C20:4, C22:5, and C22:6 decreased; serum amino acids, including tyrosine, alanine, and aminobutyric acid, increased, whereas histidine and glycine decreased ( < 0.05). Among these serum fatty acids and amino acids, changes in C14:0, C20:4, tyrosine, histidine, and glycine were also observed in RCT 2. An indicator was developed based on the five fatty acids and amino acids, namely, C14:0 × tyrosine × 1,000/[C20:4 × (glycine + histidine)], and it significantly identified participants in the intervention group with area under the curve (AUC) (95% CI) being 0.85 (0.77-0.92). The indicator was significantly associated with incidence of T2DM in the prospective cohort with HRs (95% CIs) from bottom quartile to top quartile being 1,1.21 (0.82-1.77), 1.60 (1.12-2.30), 2.04 (1.42-2.94).
CONCLUSION
The newly developed indicator in RCTs can be used in assessing the nutritional status of hypercaloric intake of SFA and predicting the development of T2DM.
目的
现代社会中饱和脂肪酸（SFA）的高热量摄入很常见，这可能是导致2型糖尿病（T2DM）流行的原因之一。本研究进行了两项随机对照试验（RCT），以开发一种能够评估营养状况的新指标，并研究其与T2DM发病率的关联。
方法
在RCT 1中，健康参与者被随机分为三组，即对照组（n = 40）、过量喂养组1（每天100克黄油，n = 37）和过量喂养组2（每天120克黄油，n = 37）。在RCT 2中，健康受试者被随机分为两组，即对照组（n = 52）和高脂肪组（通过高脂饮食设计的饮食每天额外摄入300千卡热量，n = 58）。在前瞻性队列中，纳入了4057名年龄在20 - 74岁之间的参与者，并进行了5.3年的随访。测量了血清脂肪酸和氨基酸谱。
结果
在RCT 1中，血清脂肪酸，包括C14:0和C18:0增加，而C18:2、C20:4、C22:5和C22:6减少；血清氨基酸，包括酪氨酸、丙氨酸和氨基丁酸增加，而组氨酸和甘氨酸减少（P < 0.05）。在这些血清脂肪酸和氨基酸中，RCT 2中也观察到了C14:0、C20:4、酪氨酸、组氨酸和甘氨酸的变化。基于这五种脂肪酸和氨基酸开发了一个指标，即C14:0×酪氨酸×1000/[C20:4×（甘氨酸 + 组氨酸）]，它能够显著识别干预组中的参与者，曲线下面积（AUC）（95%CI）为0.85（0.77 - 0.92）。该指标在前瞻性队列中与T2DM的发病率显著相关，四分位数间距从低到高的风险比（HRs）（95%CI）分别为1、1.21（0.82 - 1.77）、1.60（1.12 - 2.30）、2.04（1.42 - 2.94）。
结论
RCT中新开发的指标可用于评估SFA高热量摄入的营养状况，并预测T2DM的发展。
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