Efficacy of increased resistant starch consumption in human type 2 diabetes.
Efficacy of increased resistant starch consumption in human type 2 diabetes.
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DOI：
10.1530/ec-14-0036
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发表时间：
2014
影响因子：
2.9
通讯作者：
Robertson MD
中科院分区：
文献类型：
--
作者：
Bodinham CL;Smith L;Thomas EL;Bell JD;Swann JR;Costabile A;Russell-Jones D;Umpleby AM;Robertson MD
抗性淀粉（RS）已被证明有益于影响健康个体和代谢综合征患者的胰岛素敏感性，但其对人类2型糖尿病（T2 DM）的影响尚不清楚。本研究旨在确定RS摄入量增加对T2 DM患者胰岛素敏感性和血糖控制以及餐后代谢物和体脂变化的影响。17名控制良好的T2 DM（HbA 1c 46.6±2 mmol/mol）受试者以随机顺序每天服用40 g 2型RS（HAM-RS 2）或安慰剂，持续12周，其间有12周的洗脱期。 在每个干预期结束时，参与者参加了三项代谢研究：两步正常血糖-高胰岛素钳夹结合[6，6 - 2 H2]葡萄糖输注，餐耐量试验（MTT），前臂动静脉采样和全身成像。HAM-RS 2导致餐后葡萄糖浓度显著降低（P=0.045），前臂肌肉葡萄糖摄取增加（P=0.077）;然而，HAM-RS 2对肝脏或外周胰岛素敏感性或HbA 1c无影响。空腹非酯化脂肪酸（NEFA）浓度显著较低（P=0.004），并且在HAM-RS 2钳夹期间NEFA抑制更大（P=0.001）。空腹甘油三酯（TG）浓度和比目鱼肌肌内TG浓度显着较高的消耗HAM-RS 2（P=0.039和P=0.027分别）。尽管空腹GLP 1浓度在HAM-RS 2消耗后显著降低（P=0.049），但在MTT期间餐后GLP 1波动显著更大（P=0.009）。在控制良好的T2 DM患者中，HAM-RS 2未改善组织胰岛素敏感性，但对膳食处理表现出有益作用，可能是由于餐后GLP 1较高。
Resistant starch (RS) has been shown to beneficially affect insulin sensitivity in healthy individuals and those with metabolic syndrome, but its effects on human type 2 diabetes (T2DM) are unknown. This study aimed to determine the effects of increased RS consumption on insulin sensitivity and glucose control and changes in postprandial metabolites and body fat in T2DM. Seventeen individuals with well-controlled T2DM (HbA1c 46.6±2 mmol/mol) consumed, in a random order, either 40 g of type 2 RS (HAM-RS2) or a placebo, daily for 12 weeks with a 12-week washout period in between. At the end of each intervention period, participants attended for three metabolic investigations: a two-step euglycemic–hyperinsulinemic clamp combined with an infusion of [6,6-2H2] glucose, a meal tolerance test (MTT) with arterio-venous sampling across the forearm, and whole-body imaging. HAM-RS2 resulted in significantly lower postprandial glucose concentrations (P=0.045) and a trend for greater glucose uptake across the forearm muscle (P=0.077); however, there was no effect of HAM-RS2 on hepatic or peripheral insulin sensitivity, or on HbA1c. Fasting non-esterified fatty acid (NEFA) concentrations were significantly lower (P=0.004) and NEFA suppression was greater during the clamp with HAM-RS2 (P=0.001). Fasting triglyceride (TG) concentrations and soleus intramuscular TG concentrations were significantly higher following the consumption of HAM-RS2 (P=0.039 and P=0.027 respectively). Although fasting GLP1 concentrations were significantly lower following HAM-RS2 consumption (P=0.049), postprandial GLP1 excursions during the MTT were significantly greater (P=0.009). HAM-RS2 did not improve tissue insulin sensitivity in well-controlled T2DM, but demonstrated beneficial effects on meal handling, possibly due to higher postprandial GLP1.