Effects of a low-carbohydrate diet on insulin-resistant dyslipoproteinemia-a randomized controlled feeding trial.
Effects of a low-carbohydrate diet on insulin-resistant dyslipoproteinemia-a randomized controlled feeding trial.
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DOI：
10.1093/ajcn/nqab287
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发表时间：
2022-01-11
期刊：
影响因子：
--
通讯作者：
Ludwig DS
中科院分区：
文献类型：
--
作者：
Ebbeling CB;Knapp A;Johnson A;Wong JMW;Greco KF;Ma C;Mora S;Ludwig DS
碳水化合物限制显示出对糖尿病的承诺，但对低碳水化合物饮食中高饱和脂肪含量的担忧限制了广泛采用。这项预先计划的辅助研究旨在确定碳水化合物和饱和脂肪含量变化很大的饮食如何影响减肥期间心血管疾病（CVD）的风险因素。在导入饮食中体重减轻10 - 14%后，164名参与者（70%女性; BMI = 32.4 ± 4.8 kg/m2）被随机分配到3种减肥维持饮食中，持续20周。所制备的饮食含有20%的蛋白质，并且碳水化合物（碳水化合物）和饱和脂肪作为能量的比例不同3倍（低碳水化合物：20%碳水化合物，21%饱和脂肪;中等碳水化合物：40%，14%;高碳水化合物：60%，7%）。在随机化前和第20周采集空腹血浆样本。脂蛋白胰岛素抵抗（LPIR）评分根据富含甘油三酯、高密度和低密度脂蛋白颗粒（TRL-P、HDL-P、LDL-P）大小和亚组分浓度（大/非常大TRL-P、大HDL-P、小LDL-P）计算。其他结局包括脂蛋白（a）、甘油三酯、HDL胆固醇、LDL胆固醇、脂联素和炎症标志物。重复测量ANOVA用于意向治疗分析。保留率为90%。LPIR（量表0 - 100）的平均变化因饮食而异，呈剂量依赖性：低碳水化合物（-5.3; 95%CI：-9.2，-1.5）、中碳水化合物（-0.02; 95%CI：-4.1，4.1）、高碳水化合物（3.6; 95%CI：-0.6，7.7），P = 0.009。低碳水化合物也对脂蛋白（a）[分别为-14.7%（95% CI：-19.5，-9.5）、-2.1（95% CI：-8.2，4.3）和0.2（95% CI：-6.0，6.8）; P = 0.0005]、甘油三酯、HDL胆固醇、大/非常大TRL-P、大HDL-P和脂联素产生了有利影响。低密度脂蛋白胆固醇、低密度脂蛋白-P和炎症标志物在不同饮食之间没有差异。低碳水化合物饮食，高饱和脂肪，改善胰岛素抵抗性异常脂蛋白血症和脂蛋白（a），对LDL胆固醇无不良影响。碳水化合物限制可能独立于体重降低CVD风险，这一可能性值得在主要的多中心试验中进行研究。该登记册可通过www.example.com查阅：www.example.com。
Carbohydrate restriction shows promise for diabetes, but concerns regarding high saturated fat content of low-carbohydrate diets limit widespread adoption. This preplanned ancillary study aimed to determine how diets varying widely in carbohydrate and saturated fat affect cardiovascular disease (CVD) risk factors during weight-loss maintenance. After 10–14% weight loss on a run-in diet, 164 participants (70% female; BMI = 32.4 ± 4.8 kg/m2) were randomly assigned to 3 weight-loss maintenance diets for 20 wk. The prepared diets contained 20% protein and differed 3-fold in carbohydrate (Carb) and saturated fat as a proportion of energy (Low-Carb: 20% carbohydrate, 21% saturated fat; Moderate-Carb: 40%, 14%; High-Carb: 60%, 7%). Fasting plasma samples were collected prerandomization and at 20 wk. Lipoprotein insulin resistance (LPIR) score was calculated from triglyceride-rich, high-density, and low-density lipoprotein particle (TRL-P, HDL-P, LDL-P) sizes and subfraction concentrations (large/very large TRL-P, large HDL-P, small LDL-P). Other outcomes included lipoprotein(a), triglycerides, HDL cholesterol, LDL cholesterol, adiponectin, and inflammatory markers. Repeated measures ANOVA was used for intention-to-treat analysis. Retention was 90%. Mean change in LPIR (scale 0–100) differed by diet in a dose-dependent fashion: Low-Carb (–5.3; 95% CI: –9.2, –1.5), Moderate-Carb (–0.02; 95% CI: –4.1, 4.1), High-Carb (3.6; 95% CI: –0.6, 7.7), P = 0.009. Low-Carb also favorably affected lipoprotein(a) [–14.7% (95% CI: –19.5, –9.5), –2.1 (95% CI: –8.2, 4.3), and 0.2 (95% CI: –6.0, 6.8), respectively; P = 0.0005], triglycerides, HDL cholesterol, large/very large TRL-P, large HDL-P, and adiponectin. LDL cholesterol, LDL-P, and inflammatory markers did not differ by diet. A low-carbohydrate diet, high in saturated fat, improved insulin-resistant dyslipoproteinemia and lipoprotein(a), without adverse effect on LDL cholesterol. Carbohydrate restriction might lower CVD risk independently of body weight, a possibility that warrants study in major multicentered trials powered on hard outcomes. The registry is available through ClinicialTrials.gov: https://clinicaltrials.gov/ct2/show/NCT02068885.
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影响因子：
4.4
作者：
Goldberg IJ;Ibrahim N;Bredefeld C;Foo S;Lim V;Gutman D;Huggins LA;Hegele RA
通讯作者：
Hegele RA
影响因子：
--
作者：
Jeppesen, J;Hein, HO;Gyntelberg, F
通讯作者：
Gyntelberg, F
影响因子：
7.1
作者：
Jakobsen, Marianne U.;Dethlefsen, Claus;Overvad, Kim
通讯作者：
Overvad, Kim
影响因子：
24
作者：
Dugani SB;Akinkuolie AO;Paynter N;Glynn RJ;Ridker PM;Mora S
通讯作者：
Mora S
DOI：
10.1136/bmj.k4583
发表时间：
2018-11-14
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Ebbeling CB;Feldman HA;Klein GL;Wong JMW;Bielak L;Steltz SK;Luoto PK;Wolfe RR;Wong WW;Ludwig DS
通讯作者：
Ludwig DS