Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial1234
Effect of changing the amount and type of fat and carbohydrate on insulin sensitivity and cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and Kings) trial1234
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改变脂肪和碳水化合物的数量和类型对胰岛素敏感性和心血管风险的影响：RISCK（雷丁、帝国、萨里、剑桥和国王）试验1234
DOI：
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发表时间：
2010
影响因子：
7.1
通讯作者：
T. Sanders
中科院分区：
文献类型：
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作者：
S. Jebb;J. Lovegrove;B. Griffin;G. Frost;Carmel S Moore;M. Chatfield;L. Bluck;Christine M. Williams;T. Sanders
背景
胰岛素敏感性(SI)是通过减肥和锻炼来改善的，但用单不饱和脂肪酸(MUFAs)或高血糖指数(HGI)或低血糖指数(LGI)的碳水化合物取代饱和脂肪酸(SFA)的效果尚不确定。
客观化
我们进行了一项饮食干预试验，以研究这些对有患代谢综合征风险的参与者的影响。
设计
我们进行了一项5中心、平行设计、随机对照试验[RISCK(Reding、Imperial、Surrey、Cambridge和Kings)]。主要和次要结果是SI(通过静脉葡萄糖耐量试验测量)和心血管危险因素的变化。在高SFA和HGI(HS/HGI)饮食4wk后，以HS/HGI(参照物)、高MUFA和HGI(HM/HGI)、HM和LGI(HM/LGI)、低脂和HGI(LF/HGI)和LF和LGI(LF/LGI)饮食干预24周后进行测量。
结果
我们分析了随机分配到治疗组的720名参与者中的548人的数据。μU(-1)·min(-1)(四分位数范围：2.0，4.2×10-4mL·μU(-1)·min(-1))，治疗2 4wk后未调整的平均百分比变化(95%顺式)为：HS/HGI组-4%(-12.7%，5.3%)；HM/HGI组为2.1%(-5.8%，10.7%)；HM/LGI组为-3.5%(-10.6%，4.3%)；LF/HGI组为-8.6%(-15.4%，-1.1%)；LF/LGI组为9.9%(2.4%，18.0%)。总胆固醇(TC)、低密度脂蛋白(LDL)和载脂蛋白B浓度随着SFA的减少而降低。LGI组TC和低密度脂蛋白-胆固醇浓度的下降幅度更大。减脂可降低高密度脂蛋白胆固醇和载脂蛋白A1和B的浓度。
结论
这项研究不支持等能用MUFA或碳水化合物取代SFA对Si有有利影响的假说。降低GI可促进受试者TC和低密度脂蛋白-胆固醇浓度的降低，初步证据表明，LF治疗组的SI有所改善。这项试验在Clinicaltrials.gov上注册为ISRCTN29111298。
BACKGROUND
Insulin sensitivity (Si) is improved by weight loss and exercise, but the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain.
OBJECTIVE
We conducted a dietary intervention trial to study these effects in participants at risk of developing metabolic syndrome.
DESIGN
We conducted a 5-center, parallel design, randomized controlled trial [RISCK (Reading, Imperial, Surrey, Cambridge, and Kings)]. The primary and secondary outcomes were changes in Si (measured by using an intravenous glucose tolerance test) and cardiovascular risk factors. Measurements were made after 4 wk of a high-SFA and HGI (HS/HGI) diet and after a 24-wk intervention with HS/HGI (reference), high-MUFA and HGI (HM/HGI), HM and LGI (HM/LGI), low-fat and HGI (LF/HGI), and LF and LGI (LF/LGI) diets.
RESULTS
We analyzed data for 548 of 720 participants who were randomly assigned to treatment. The median Si was 2.7 × 10(-4) mL · μU(-1) · min(-1) (interquartile range: 2.0, 4.2 × 10(-4) mL · μU(-1) · min(-1)), and unadjusted mean percentage changes (95% CIs) after 24 wk treatment (P = 0.13) were as follows: for the HS/HGI group, -4% (-12.7%, 5.3%); for the HM/HGI group, 2.1% (-5.8%, 10.7%); for the HM/LGI group, -3.5% (-10.6%, 4.3%); for the LF/HGI group, -8.6% (-15.4%, -1.1%); and for the LF/LGI group, 9.9% (2.4%, 18.0%). Total cholesterol (TC), LDL cholesterol, and apolipoprotein B concentrations decreased with SFA reduction. Decreases in TC and LDL-cholesterol concentrations were greater with LGI. Fat reduction lowered HDL cholesterol and apolipoprotein A1 and B concentrations.
CONCLUSIONS
This study did not support the hypothesis that isoenergetic replacement of SFAs with MUFAs or carbohydrates has a favorable effect on Si. Lowering GI enhanced reductions in TC and LDL-cholesterol concentrations in subjects, with tentative evidence of improvements in Si in the LF-treatment group. This trial was registered at clinicaltrials.gov as ISRCTN29111298.
影响因子：
7.1
作者：
Garg, A
通讯作者：
Garg, A