Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetes.
Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetes.
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DOI：
10.1111/j.1464-5491.2010.03209.x
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发表时间：
2011-05
期刊：
影响因子：
--
通讯作者：
Pelikanova T
中科院分区：
文献类型：
--
作者：
Kahleova H;Matoulek M;Malinska H;Oliyarnik O;Kazdova L;Neskudla T;Skoch A;Hajek M;Hill M;Kahle M;Pelikanova T
本研究的目的是比较热量限制的素食和传统的糖尿病饮食单独和结合运动对2型糖尿病受试者的胰岛素抵抗，内脏脂肪和氧化应激标志物的影响。采用24周、随机、开放、平行设计。74例2型糖尿病患者被随机分配到实验组（n = 37），接受素食饮食，或对照组（n = 37），接受传统的糖尿病饮食。两种饮食都是等热量的，热量限制（~ 500千卡/天）。研究期间提供所有膳食。第二个12周的饮食与有氧运动相结合。参与者在基线，12周和24周进行了检查。主要结局为：通过高胰岛素血等血糖钳夹测量的胰岛素敏感性;通过磁共振成像测量的内脏和皮下脂肪体积;和通过硫代巴比妥酸反应物质测量的氧化应激。实验组43%的参与者和对照组5%的参与者减少了糖尿病药物治疗（P < 0.001）。实验组的体重下降幅度大于对照组[-6.2 kg（95% CI -6.6至-5.3）vs. -3.2 kg（95% CI -3.7至-2.5）;相互作用组×时间P = 0.001]。实验组胰岛素敏感性的增加显著大于对照组[30%（95% CI 24.5-39）vs. 20%（95% CI 14-25），P = 0.04]。实验组的内脏和皮下脂肪减少量大于对照组（分别为P = 0.007和P = 0.02）。实验组血浆脂联素升高（P = 0.02），瘦素降低（P = 0.02），对照组无变化。维生素C、超氧化物歧化酶和还原型谷胱甘肽在实验组升高（分别为P = 0.002、P < 0.001和P = 0.02）。在增加运动训练后，组间差异更大。胰岛素敏感性和酶氧化应激标志物的变化与内脏脂肪的变化相关。在24周内，与传统的糖尿病饮食相比，热量限制的素食饮食具有更大的改善胰岛素敏感性的能力。内脏脂肪的更大损失和脂肪因子和氧化应激标记物的血浆浓度的改善，这种饮食可能是减少胰岛素抵抗的原因。运动训练的增加进一步增强了素食的改善效果。
The aim of this study was to compare the effects of calorie-restricted vegetarian and conventional diabetic diets alone and in combination with exercise on insulin resistance, visceral fat and oxidative stress markers in subjects with Type 2 diabetes. A 24-week, randomized, open, parallel design was used. Seventy-four patients with Type 2 diabetes were randomly assigned to either the experimental group (n = 37), which received a vegetarian diet, or the control group (n = 37), which received a conventional diabetic diet. Both diets were isocaloric, calorie restricted (-500 kcal/day). All meals during the study were provided. The second 12 weeks of the diet were combined with aerobic exercise. Participants were examined at baseline, 12 weeks and 24 weeks. Primary outcomes were: insulin sensitivity measured by hyperinsulinaemic isoglycaemic clamp; volume of visceral and subcutaneous fat measured by magnetic resonance imaging; and oxidative stress measured by thiobarbituric acid reactive substances. Analyses were by intention to treat. Forty-three per cent of participants in the experimental group and 5% of participants in the control group reduced diabetes medication (P < 0.001). Body weight decreased more in the experimental group than in the control group [–6.2 kg (95% CI –6.6 to –5.3) vs. –3.2 kg (95% CI –3.7 to –2.5); interaction group × time P = 0.001]. An increase in insulin sensitivity was significantly greater in the experimental group than in the control group [30% (95% CI 24.5–39) vs. 20% (95% CI 14–25), P = 0.04]. A reduction in both visceral and subcutaneous fat was greater in the experimental group than in the control group (P = 0.007 and P = 0.02, respectively). Plasma adiponectin increased (P = 0.02) and leptin decreased (P = 0.02) in the experimental group, with no change in the control group. Vitamin C, superoxide dismutase and reduced glutathione increased in the experimental group (P = 0.002, P < 0.001 and P = 0.02, respectively). Differences between groups were greater after the addition of exercise training. Changes in insulin sensitivity and enzymatic oxidative stress markers correlated with changes in visceral fat. A calorie-restricted vegetarian diet had greater capacity to improve insulin sensitivity compared with a conventional diabetic diet over 24 weeks. The greater loss of visceral fat and improvements in plasma concentrations of adipokines and oxidative stress markers with this diet may be responsible for the reduction of insulin resistance. The addition of exercise training further augmented the improved outcomes with the vegetarian diet.
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影响因子：
2.9
作者：
Nakagawa, K;Kanno, H;Miura, Y
通讯作者：
Miura, Y
DOI：
10.1038/oby.2004.8
发表时间：
2004-01-01
期刊：
OBESITY RESEARCH
影响因子：
--
作者：
Patrick, DL;Bushnell, DM;Rothman, M
通讯作者：
Rothman, M
影响因子：
4.7
作者：
Goff, LM;Bell, JD;Frost, GS
通讯作者：
Frost, GS
影响因子：
5.3
作者：
Strandberg, Timo E.;Gylling, Helena;Miettinen, Tatu A.
通讯作者：
Miettinen, Tatu A.
影响因子：
3.2
作者：
Hagstromer, Maria;Oja, Pekka;Sjostrom, Michael
通讯作者：
Sjostrom, Michael