血清短链脂肪酸与血糖控制的性别特异性关联：一项针对意大利1型糖尿病成年患者的横断面研究。

Sex-specific associations of serum short-chain fatty acids with glycaemic control: an Italian cross-sectional study in adults with type 1 diabetes.

作者信息

Abuqwider Jumana, Salamone Dominic, Scidà Giuseppe, Corrado Alessandra, Costabile Giuseppina, Luongo Delia, Annuzzi Giovanni, Rivellese Angela, Bozzetto Lutgarda

机构信息

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

National Research Council, Institute of Biostructures and Bioimaging, Napoli, Italy.

出版信息

BMJ Open. 2025 Mar 24;15(3):e096994. doi: 10.1136/bmjopen-2024-096994.

DOI:10.1136/bmjopen-2024-096994

PMID:40132856

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11934402/

Abstract

OBJECTIVE

Short-chain fatty acids (SCFA) play a role in modulating glucose metabolism and are influenced by diet. Alterations in the SCFA-producing microbial ecosystem in individuals with type 1 diabetes (T1D) may contribute to impaired glycaemic control. This study investigated the relationships between serum SCFA levels, blood glucose control, and dietary habits in adults with T1D.

DESIGN

Observational study.

SETTING

The study was conducted at the diabetes outpatient clinic of Federico II University Teaching Hospital, Naples, Italy.

POPULATION

The study included 198 adults with T1D (100 men and 98 women), aged 18-79 years.

MAIN OUTCOME MEASURES

Serum SCFA levels, blood glucose control, assessed by glycated haemoglobin (HbA1c) and continuous glucose monitoring (CGM) metrics, and dietary intake from a 7-day food record.

RESULTS

SCFA levels showed significant sex-specific differences (p<0.05). Therefore, to evaluate relationships between SCFA levels, glycaemic control and dietary habits, SCFA levels were categorised into sex-specific tertiles, and results were adjusted for age and body mass index. HbA1c and CGM metrics did not vary significantly across tertiles of acetate and butyrate. However, in women, higher propionate levels were associated with better glycaemic control, reflected by a greater percentage of glucose time-in-range (70-180 mg/dL) (66.2±12.3% vs 56.9±16.7%, low tertile; p=0.014), lower time-above-range (>180 mg/dL) (32.2±12.6% vs 41.2±17.2%, low tertile; p=0.011) and improved glucose management indicator (7.1±0.6% vs 7.5±0.6%, low tertile; p=0.027). Regarding eating habits, higher acetate tertiles were associated with higher intakes of total fat (p=0.041), polyunsaturated fatty acids (p=0.049) and monounsaturated fatty acids (p=0.021) in men only.

CONCLUSION

These findings reveal a sex-specific association between serum propionate levels and blood glucose control in women with T1D. Importantly, this relationship appears independent of dietary factors.

TRIAL REGISTRATION NUMBER

NCT05936242.

摘要

目的

短链脂肪酸（SCFA）在调节葡萄糖代谢中起作用，并受饮食影响。1型糖尿病（T1D）患者中产生SCFA的微生物生态系统的改变可能导致血糖控制受损。本研究调查了成年T1D患者血清SCFA水平、血糖控制和饮食习惯之间的关系。

设计

观察性研究。

地点

该研究在意大利那不勒斯费德里科二世大学教学医院的糖尿病门诊进行。

研究对象

该研究纳入了198名年龄在18 - 79岁之间的成年T1D患者（100名男性和98名女性）。

主要观察指标

血清SCFA水平、通过糖化血红蛋白（HbA1c）和持续葡萄糖监测（CGM）指标评估的血糖控制，以及来自7天食物记录的饮食摄入量。

结果

SCFA水平显示出显著的性别差异（p<0.05）。因此，为了评估SCFA水平、血糖控制和饮食习惯之间的关系，将SCFA水平按性别分为三分位数，并对年龄和体重指数进行了结果调整。醋酸盐和丁酸盐的三分位数中，HbA1c和CGM指标没有显著差异。然而，在女性中，较高的丙酸盐水平与更好的血糖控制相关，表现为血糖在目标范围内（70 - 180mg/dL）的时间百分比更高（66.2±12.3%对56.9±16.7%，低三分位数；p = 0.014），高于目标范围（>180mg/dL）的时间更低（32.2±12.6%对41.2±17.2%，低三分位数；p = 0.011），以及葡萄糖管理指标改善（7.1±0.6%对7.5±0.6%，低三分位数；p = 照027）。关于饮食习惯，仅在男性中，较高的醋酸盐三分位数与总脂肪（p = 0.041）、多不饱和脂肪酸（p =照049）和单不饱和脂肪酸（p = 0.021）的摄入量较高相关。