Daley Tanicia C, Cousineau Benjamin A, Nesbeth Paula-Dene C, Ivie Elizabeth A, Bellissimo Moriah P, Easley Kirk A, Vellanki Priyathama, Vos Miriam B, Hunt William R, Stecenko Arlene A, Ziegler Thomas R, Alvarez Jessica A
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States.
Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States.
Front Nutr. 2023 Sep 20;10:1158452. doi: 10.3389/fnut.2023.1158452. eCollection 2023.
Poor diet quality contributes to metabolic dysfunction. This study aimed to gain a greater understanding of the relationship between dietary macronutrient quality and glucose homeostasis in adults with cystic fibrosis (CF).
This was a cross-sectional study of = 27 adults with CF with glucose tolerance ranging from normal ( = 9) to prediabetes ( = 6) to being classified as having cystic fibrosis-related diabetes (CFRD, = 12). Fasted blood was collected for analysis of glucose, insulin, and C-peptide. Insulin resistance was assessed by Homeostatic Model Assessment for Insulin Resistance (HOMA2-IR). Subjects without known CFRD also underwent a 2-h oral glucose tolerance test. Three-day food records were used to assess macronutrient sources. Dietary variables were adjusted for energy intake. Statistical analyses included ANOVA, Spearman correlations, and multiple linear regression.
Individuals with CFRD consumed less total fat and monounsaturated fatty acids (MUFA) compared to those with normal glucose tolerance ( < 0.05). In Spearman correlation analyses, dietary glycemic load was inversely associated with C-peptide (rho = -0.28, = 0.05). Total dietary fat, MUFA, and polyunsaturated fatty acids (PUFA) were positively associated with C-peptide (rho = 0.39-0.41, all < 0.05). Plant protein intake was inversely related to HOMA2-IR (rho = -0.28, = 0.048). Associations remained significant after adjustment for age and sex.
Improvements in diet quality are needed in people with CF. This study suggests that higher unsaturated dietary fat, higher plant protein, and higher carbohydrate quality were associated with better glucose tolerance indicators in adults with CF. Larger, prospective studies in individuals with CF are needed to determine the impact of diet quality on the development of CFRD.
不良的饮食质量会导致代谢功能障碍。本研究旨在更深入地了解囊性纤维化（CF）成人患者饮食中宏量营养素质量与葡萄糖稳态之间的关系。
这是一项横断面研究，纳入了27名CF成人患者，其葡萄糖耐量范围从正常（n = 9）到糖尿病前期（n = 6）再到被归类为患有囊性纤维化相关糖尿病（CFRD，n = 12）。采集空腹血样用于分析葡萄糖、胰岛素和C肽。通过稳态模型评估胰岛素抵抗（HOMA2-IR）来评估胰岛素抵抗。未患已知CFRD的受试者还进行了2小时口服葡萄糖耐量试验。采用3天食物记录来评估宏量营养素来源。根据能量摄入对饮食变量进行调整。统计分析包括方差分析、Spearman相关性分析和多元线性回归。
与葡萄糖耐量正常的个体相比，CFRD个体摄入的总脂肪和单不饱和脂肪酸（MUFA）较少（P < 0.05）。在Spearman相关性分析中，饮食血糖负荷与C肽呈负相关（rho = -0.28，P = 0.05）。饮食中的总脂肪、MUFA和多不饱和脂肪酸（PUFA）与C肽呈正相关（rho = 0.39 - 0.41，均P < 0.05）。植物蛋白摄入量与HOMA2-IR呈负相关（rho = -0.28，P = 0.048）。在调整年龄和性别后，这些关联仍然显著。
CF患者需要改善饮食质量。本研究表明，在CF成人患者中，较高的不饱和饮食脂肪、较高的植物蛋白和较高的碳水化合物质量与更好的葡萄糖耐量指标相关。需要对CF个体进行更大规模的前瞻性研究，以确定饮食质量对CFRD发生发展的影响。
