Effects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetes.
Effects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetes.
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DOI：
10.2147/dmso.s19635
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Wakai K
中科院分区：
文献类型：
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作者：
Sasakabe T;Haimoto H;Umegaki H;Wakai K
报告显示，内脏脂肪组织（VAT）比皮下脂肪组织（SAT）与心血管危险因素（CRF）的关系更为密切。我们的目的是阐明 2 型糖尿病 (T2DM) 患者通过适度低碳水化合物饮食 (LCD) 优先减少腹部脂肪，以及腹部脂肪减少与 CRF 变化之间的相关性。 52 名血红蛋白 A1c (HbAlc) 水平 ≥ 6.5% 的门诊患者（28 名男性和 24 名女性，平均年龄 ± SD：60.0 ± 10.5 岁）接受了 6 个月的 LCD 治疗。在 6 个月的时间内，我们测量了他们的腹部脂肪分布（使用 CT）并评估了 CRF，包括体重指数 (BMI)、HbA1c、空腹血糖 (FBG)、血清胰岛素、高密度脂蛋白胆固醇 (HDL-C)、低密度脂蛋白胆固醇 (LDL-C) 和甘油三酯水平。患者对 LCD 表现出良好的依从性（男性 1812 ± 375 kcal/天，%碳水化合物:脂肪:蛋白质 = 35:40:19；女性 1706 ± 323 kcal/天，%碳水化合物:脂肪:蛋白质 = 41:36:21）。观察到男性 BMI 和 HbA1c 水平显着降低 (P = 0.05)，同时 HDL-C 升高 (P = 0.021)，女性 LDL-C 降低 (P = 0.001)。 VAT（男性-21.6 cm2，P < 0.001；女性-19.6 cm2，P < 0.001）和SAT（男性-13.5 cm2，P = 0.004；女性-19.1 cm2，P = 0.003）显着下降。女性的增值税 (%ΔVAT) 损失大于 SAT (%ΔSAT)（P = 0.022）。在男性中也发现了类似但不显着的增值税损失优势（P = 0.111）。在女性中，%ΔSAT 与 FBG (ΔFBG) (r = 0.417) 和 HDL-C (ΔHDL) (r = -0.720) 的变化显着相关，%ΔVAT 与甘油三酯 (ΔTG) 的变化 (r = 0.591) 显着相关。六个月的中等 LCD 导致仅女性享受增值税优惠减免，%ΔSAT 与 ΔHDL 和 ΔFBG 之间以及 %ΔVAT 和 ΔTG 之间存在显着相关性。我们的研究结果表明，LCD 有可能减少 T2DM 患者的腹部脂肪和血脂状况恶化。
Reports have shown that visceral adipose tissue (VAT) is more closely linked to cardiovascular risk factors (CRFs) than subcutaneous adipose tissue (SAT). We aimed to elucidate preferential abdominal fat loss and the correlations between abdominal fat reductions and changes in CRFs achieved with a moderate low-carbohydrate diet (LCD) in patients with type 2 diabetes (T2DM). Fifty-two outpatients (28 men and 24 women, mean age ± SD: 60.0 ± 10.5 years) with hemoglobin A1c (HbAlc) levels ≥ 6.5% were on an LCD for 6 months. Over a 6-month period, we measured their abdominal fat distribution (using CT) and assessed CRFs, including body mass index (BMI), HbA1c, fasting blood glucose (FBG), serum insulin, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride levels. The patients showed good compliance with the LCD (1812 ± 375 kcal/day, % carbohydrate:fat:protein = 35:40:19 for men; 1706 ± 323 kcal/day, % carbohydrate:fat:protein = 41:36:21 for women). Significant decreases (P = 0.05) in BMI and HbA1c levels were observed, along with an increase in HDL-C (P = 0.021) in men and a decrease in LDL-C (P = 0.001) in women. VAT (−21.6 cm2, P < 0.001 in men; −19.6 cm2, P < 0.001 in women) and SAT (−13.5 cm2, P = 0.004 in men; −19.1 cm2, P = 0.003 in women) significantly decreased. The loss of VAT (%ΔVAT) was greater than that of SAT (%ΔSAT) in women (P = 0.022). A similar but not significant predominance of VAT loss was detected in men (P = 0.111). In women, the %ΔSAT significantly correlated with changes in FBG (ΔFBG) (r = 0.417) and HDL-C (ΔHDL) (r = −0.720), as was %ΔVAT with changes in triglyceride (ΔTG) (r = 0.591). Six months of a moderate LCD resulted in preferential VAT loss only in women, with significant correlations between %ΔSAT and both ΔHDL and ΔFBG, as well as between %ΔVAT and ΔTG. Our results suggest that an LCD has the potential to reduce abdominal fat in patients with T2DM and deterioration of serum lipid profiles.