一项等能量多因素饮食干预可降低 2 型糖尿病患者胰腺脂肪含量并增加餐后胰岛素反应：一项随机对照试验。

An Isoenergetic Multifactorial Diet Reduces Pancreatic Fat and Increases Postprandial Insulin Response in Patients With Type 2 Diabetes: A Randomized Controlled Trial.

机构信息

Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.

IRCCS Synlab SDN, Naples, Italy.

出版信息

Diabetes Care. 2022 Sep 1;45(9):1935-1942. doi: 10.2337/dc22-0605.

DOI:10.2337/dc22-0605

PMID:35862001

Abstract

OBJECTIVE

To compare the effect of an isocaloric multifactorial diet with a diet rich in monounsaturated fatty acids (MUFA) and similar macronutrient composition on pancreatic fat (PF) and postprandial insulin response in type 2 diabetes (T2D).

RESEARCH DESIGN AND METHODS

According to a randomized controlled parallel-group design, 39 individuals with T2D, 35-75 years old, in satisfactory blood glucose control, were assigned to an 8 week isocaloric intervention with a multifactorial diet rich in MUFA, polyunsaturated fatty acids, fiber, polyphenols, and vitamins (n = 18) or a MUFA-rich diet (n = 21). Before/after the intervention, PF content was measured by the proton-density fat fraction using a three-dimensional mDIXON MRI sequence, and plasma insulin and glucose concentrations were measured over a 4 h test meal with a similar composition as the assigned diet.

RESULTS

After 8 weeks, PF significantly decreased after the multifactorial diet (from 15.7 ± 6.5% to 14.1 ± 6.3%; P = 0.024), while it did not change after the MUFA diet (from 17.1 ± 10.1% to 18.6 ± 10.6%; P = 0.139) with a significant difference between diets (P = 0.014). Postprandial glucose response was similar in the two groups. Early postprandial insulin response (incremental postprandial areas under the curve [iAUC0-120]) significantly increased with the multifactorial diet (from 36,340 ± 34,954 to 44,138 ± 31,878 pmol/L/min; P = 0.037), while it did not change significantly in the MUFA diet (from 31,754 ± 18,446 to 26,976 ± 12,265 pmol/L/min; P = 0.178), with a significant difference between diets (P = 0.023). Changes in PF inversely correlated with changes in early postprandial insulin response (r = -0.383; P = 0.023).

CONCLUSIONS

In patients with T2D, an isocaloric multifactorial diet, including several beneficial dietary components, markedly reduced PF. This reduction was associated with an improved postprandial insulin response.

摘要

目的

比较等热量多因素饮食与富含单不饱和脂肪酸（MUFA）且宏量营养素组成相似的饮食对 2 型糖尿病（T2D）患者胰腺脂肪（PF）和餐后胰岛素反应的影响。

研究设计和方法

根据随机对照平行组设计，将 39 名年龄在 35-75 岁、血糖控制满意的 T2D 患者分为 8 周等热量干预组，分别接受富含 MUFA、多不饱和脂肪酸、纤维、多酚和维生素的多因素饮食（n = 18）或富含 MUFA 的饮食（n = 21）。干预前后，采用三维 mDIXON MRI 序列测量质子密度脂肪分数以评估 PF 含量，并进行 4 小时测试餐，测试餐的组成与所分配的饮食相似，同时测量血浆胰岛素和葡萄糖浓度。

结果

8 周后，多因素饮食后 PF 显著降低（从 15.7±6.5%降至 14.1±6.3%；P=0.024），而 MUFA 饮食后 PF 无变化（从 17.1±10.1%增至 18.6±10.6%；P=0.139），两种饮食之间存在显著差异（P=0.014）。两组餐后血糖反应相似。多因素饮食后早期餐后胰岛素反应（增量餐后曲线下面积[iAUC0-120]）显著增加（从 36340±34954 增至 44138±31878 pmol/L/min；P=0.037），而 MUFA 饮食后无显著变化（从 31754±18446 增至 26976±12265 pmol/L/min；P=0.178），两种饮食之间存在显著差异（P=0.023）。PF 的变化与早期餐后胰岛素反应的变化呈负相关（r=-0.383；P=0.023）。