Acute metabolic responses to a high-carbohydrate meal in outpatients with type 2 diabetes treated with a low-carbohydrate diet: a crossover meal tolerance study.
Acute metabolic responses to a high-carbohydrate meal in outpatients with type 2 diabetes treated with a low-carbohydrate diet: a crossover meal tolerance study.
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用低碳水化合物饮食治疗的2型糖尿病的门诊患者在门诊患者中对高碳水化合物的急性代谢反应：一项跨界饮食耐受性研究。
DOI：
10.1186/1743-7075-6-52
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发表时间：
2009-12-29
影响因子：
4.5
通讯作者：
Wakai K
中科院分区：
文献类型：
--
作者：
Haimoto H;Sasakabe T;Umegaki H;Wakai K
与高碳水化合物饮食相比，低碳水化合物饮食（LCD）在2型糖尿病（T2 DM）中实现了良好的血糖控制。在能量代谢方面，尚未确定LCD T2 DM患者对高碳水化合物餐（HCM）的急性代谢反应。我们招募了31名T2 DM受试者（平均年龄：62岁，平均血红蛋白A1 c水平：6.9%），其中13名接受严格LCD（26%碳水化合物饮食），18名接受中度LCD（44%碳水化合物饮食）。在随机交叉设计中，对所有受试者进行两次等热量膳食。HCM和低碳水化合物膳食（LCM）的碳水化合物：蛋白质：脂肪比例分别为59：20：21和7：20：73。在每餐摄入后120分钟测量血清β-羟基丁酸、乙酰乙酸、游离脂肪酸（FFA）、甘油三酯和胰岛素以及血糖浓度。在所有患者中，HCM在2小时内迅速降低餐后β-羟基丁酸、乙酰乙酸和FFA浓度，同时血清胰岛素和血糖迅速升高，而LCM增加或不改变β-羟基丁酸、乙酰乙酸和FFA（P均< 0.001）。HCM在2小时内没有改变餐后甘油三酯浓度，而LCM逐渐增加它们（P < 0.001）。HCM在2小时内显著快速降低严格LCD受试者的餐后β-羟基丁酸和乙酰乙酸浓度，但在中度LCD受试者中仅轻微降低（P < 0.001，严格和中度LCD受试者之间的差异）。参数Δ酮体（120分钟时的水平-基线时的水平）与胰岛素生成指数显著相关（β-羟基丁酸酯的斯皮尔曼r = 0.503，乙酰乙酸酯的r = 0.509），但与总胰岛素分泌能力无关。此外，HCM轻微降低餐后甘油三酯水平在严格的LCD科目，但有些增加他们在中度LCD科目（P = 0.002）。Δ甘油三酯参数与背景碳水化合物百分比显著相关（斯皮尔曼相关系数r = 0.484）。在接受LCD治疗的T2 DM患者中，HCM可迅速降低餐后酮体浓度。在严格的LCD比在中度LCD的受试者的减少更显着。HCM轻微降低严格LCD受试者的餐后甘油三酯水平。参数Δ酮体与胰岛素生成指数显著相关，Δ甘油三酯与背景膳食碳水化合物%也显著相关。
A low-carbohydrate diet (LCD) achieves good glycemic control in type 2 diabetes (T2DM) compared with a high-carbohydrate diet. With respect to energy metabolism, acute metabolic responses to high-carbohydrate meals (HCMs) have not been determined in LCD patients with T2DM. We enrolled 31 subjects with T2DM (mean age: 62 yrs, mean hemoglobin A1c level: 6.9%), of whom 13 were on a strict LCD (26% carbohydrate diet), and 18 a moderate one (44% carbohydrate diet). Two isocaloric meals were administered to all subjects in a randomized crossover design. The carbohydrate:protein:fat ratios of HCMs and low-carbohydrate meals (LCMs) were 59:20:21 and 7:20:73, respectively. Serum β-hydroxybutyrate, acetoacetate, free fatty acids (FFAs), triglyceride and insulin, and plasma glucose concentrations were measured for 120 minutes after the intake of each meal. HCMs rapidly decreased postprandial β-hydroxybutyrate, acetoacetate and FFA concentrations within 2 hours in all patients in combination with rapid increases in serum insulin and plasma glucose, while LCMs increased or did not change β-hydroxybutyrate, acetoacetate and FFAs (P < 0.001 for all). HCMs did not change postprandial triglyceride concentrations over 2 hours, while LCMs gradually increased them (P < 0.001). HCMs sharply and rapidly decreased postprandial β-hydroxybutyrate and acetoacetate concentrations in strict LCD subjects over 2 hours, but only slightly decreased them in moderate LCD subjects (P < 0.001, difference between strict and moderate LCD subjects). The parameter Δketone bodies (level at 120 minutes - level at baseline) was significantly correlated with the insulinogenic index (Spearman's r = 0.503 for β-hydroxybutyrate and 0.509 for acetoacetate), but not with total insulin secretory capacity. Moreover, HCMs slightly decreased postprandial triglyceride levels in strict LCD subjects but somewhat increased them in the moderate LCD subjects (P = 0.002). The parameter Δtriglyceride was significantly correlated with background dietary %carbohydrate (Spearman's r = 0.484). HCMs rapidly decreased postprandial ketone body concentrations in T2DM patients treated with a LCD. The decreases were more remarkable in strict than in moderate LCD subjects. HCMs slightly decreased postprandial triglyceride levels in strict LCD subjects. The parameter Δketone bodies was significantly correlated with the insulinogenic index, as was Δtriglyceride with background dietary %carbohydrate.
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影响因子：
4.5
作者：
Haimoto, Hajime;Sasakabe, Tae;Umegaki, Hiroyuki
通讯作者：
Umegaki, Hiroyuki
影响因子：
--
作者：
Eberly, LE;Stamler, J;Neaton, JD
通讯作者：
Neaton, JD
影响因子：
4.8
作者：
Taggart, AKP;Kero, J;Waters, MG
通讯作者：
Waters, MG
2型糖尿病和代谢综合征的饮食碳水化合物限制：进行严格评估的时间。
影响因子：
4.5
作者：
Accurso A;Bernstein RK;Dahlqvist A;Draznin B;Feinman RD;Fine EJ;Gleed A;Jacobs DB;Larson G;Lustig RH;Manninen AH;McFarlane SI;Morrison K;Nielsen JV;Ravnskov U;Roth KS;Silvestre R;Sowers JR;Sundberg R;Volek JS;Westman EC;Wood RJ;Wortman J;Vernon MC
通讯作者：
Vernon MC
影响因子：
7.1
作者：
Johnston, Carol S.;Tjonn, Sherrie L.;Sears, Barry
通讯作者：
Sears, Barry