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

描述（由申请人提供）：在这项双盲随机对照试验中，80名（35-65岁）患有糖尿病前期（IGT/IFG）的个体将接受含有慢消化淀粉（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。我们在啮齿类动物身上的数据（得到了其他人的支持）表明，摄入缓慢可消化的淀粉：a)增强肠道微生物特征；B)减少代谢性内毒素血症；C)增加丁酸盐和丙酸盐的发酵和生产；d)增加有益肠道激素，如GLP-1和PYY；E)降低血糖负荷；因此，我们建议用一种可缓慢消化的淀粉来同时针对葡萄糖稳态中几种已知的重要机制，重点是胰岛素敏感性、脂肪氧化和异位脂肪。我们将验证以下假设，即在IGT和/或IFG患者中，每天摄入45克直链淀粉，持续3个月，改善肠道微生物群组成，进而改善T2DM发展的危险因素，如：a)胰岛素敏感性增强（FSIGTT; Aim1）；b)食欲和食物摄入减少（Aim2）；c)减少异位脂肪库（1H-MRS; Aim1）；d)降低炎症（血清标志物；Aim1）；e)以有利于代谢的方式改变大肠菌群的组成（Aim3）。这种饮食干预方法（在酸奶中添加缓慢消化的淀粉）可能比每日热量限制和运动更耐受，因此更实际地适用于治疗2型糖尿病。

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.