Role of Slowly Digestible Starch in Diabetes Risk Factors in Pre-Diabetic People

描述(申请人提供)：在这项双盲随机对照试验中，80名糖尿病前期(IGT/IFG)患者(35-65岁)将接受含有慢速可消化淀粉(直链淀粉；N=40)或“对照”淀粉(支链淀粉；N=40)的饮食，为期3个月。我们在啮齿动物身上的数据(得到其他人的支持)表明，慢速可消化淀粉的摄入：a)增强肠道微生物谱；b)减少代谢内毒素血症；c)增加丁酸盐和丙酸的发酵和产生；d)增加有益的肠道激素，如GLP-1和PYY；e)降低血糖负荷；f)抑制食欲。因此，我们建议喂食慢速消化淀粉，以同时针对已知的几种在血糖动态平衡中重要的机制，重点是胰岛素敏感性、脂肪氧化和异位脂肪。我们将测试这样一个假设，即IGT和/或IFG患者在3个月内每天摄入45g直链淀粉，肠道微生物群的组成将反过来改善T2 DM的危险因素，如：a)胰岛素敏感性增强(FSIGTT；Aim1)；b)减少食欲和食物摄入量(AIM2)；c)减少异位脂肪储存(1H-MRS；Aim1)；d)减少炎症(血清标志物；Aim1)；以及；e)以代谢有利的方式修改大肠微生物群的组成(Aim3)。这种饮食干预方法(在酸奶中添加可缓慢消化的淀粉)可能比每日热量限制和运动更耐受，因此更适用于T2 DM的治疗。

DESCRIPTION (provided by applicant): In this double-blind randomized controlled trial, 80 individuals (35-65y) with pre-diabetes (IGT/IFG) will receive either a diet containing slow digestible starch (amylose; N=40) or "control" starch (amylopectin; N=40) for 3 months. Our data in rodents (supported by others) have shown that the ingestion of slow digestible starch: a) enhances the gut microbial profile; b) reduces metabolic endotoxemia; c) increases fermentation and production of butyrate & propionate; d) increases beneficial gut hormones such as GLP-1 and PYY; e) lowers the glycemic load and; f) suppresses appetite Therefore, we propose to feed a slowly digestible starch to simultaneously target several mechanisms known to be important in glucose homeostasis with emphasis on insulin sensitivity, fat oxidation and ectopic fat. We will test the hypothesis that improved composition of the gut microbiota with a daily intake of 45 g of amylose for 3 months in individuals with IGT and/or IFG will in turn improve risk factors for the development of T2DM such as: a) enhancement of insulin sensitivity (FSIGTT; Aim1); b) decrease appetite and food intake (Aim2); c) decrease ectopic fat depots (1H-MRS; Aim1); d) decrease inflammation (serum markers; Aim1) and; e) modify the composition of large intestine microbiota in a metabolically favorable way (Aim3). This dietary intervention approach (addition of slowly digestible starch in yogurts) may prove more tolerable than daily caloric restriction and exercise and therefore more practically applicable for the treatment of T2DM.