低碳水化合物高蛋白饮食可更好地改善2型糖尿病患者的血糖水平
创作:szx 审核:szx 2019年08月03日
  • 纳入28名2型糖尿病患者,14名先摄入6周的低碳水化合物高蛋白(CRHP)饮食后,摄入6周的传统糖尿病(CD)饮食,另外14名采取相反的干预顺序;
  • 与CD饮食相比,CRHP饮食显著降低了患者的糖化血红蛋白(Hb1Ac)水平;
  • 另外,相比于CD饮食,CRHP饮食显著降低了空腹血糖、餐后血糖、肝脏脂肪含量及胰腺脂肪含量;
  • CRHP饮食未显著改变24h血压、肌肉脂肪组织、内脏脂肪组织及皮下脂肪组织。
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来自Diabetologia上发表的一项RCT结果,在28名2型糖尿病患者中发现,相比于传统的糖尿病饮食,低碳水化合物高蛋白饮食可有效地降低患者的糖化血红蛋白、空腹血糖及餐后血糖,并能够显著降低肝脏及胰腺的脂肪含量。
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Diabetologia [IF:7.518]

A carbohydrate-reduced high-protein diet improves HbA and liver fat content in weight stable participants with type 2 diabetes: a randomised controlled trial

低碳水化合物高蛋白饮食改善体重稳定的2型糖尿病患者的HbA1c及肝脏脂肪含量:一项随机对照试验

10.1007/s00125-019-4956-4

2019-07-23, Article

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Abstract:收起
AIMS/HYPOTHESIS: Dietary recommendations for treating type 2 diabetes are unclear but a trend towards recommending a diet reduced in carbohydrate content is acknowledged. We compared a carbohydrate-reduced high-protein (CRHP) diet with an iso-energetic conventional diabetes (CD) diet to elucidate the effects on glycaemic control and selected cardiovascular risk markers during 6 weeks of full food provision of each diet.
METHODS: The primary outcome of the study was change in HbA. Secondary outcomes reported in the present paper include glycaemic variables, ectopic fat content and 24 h blood pressure. Eligibility criteria were: men and women with type 2 diabetes, HbA 48-97 mmol/mol (6.5-11%), age >18 years, haemoglobin >6/>7 mmol/l (women/men) and eGFR >30 ml min (1.73 m). Participants were randomised by drawing blinded ballots to 6 + 6 weeks of an iso-energetic CRHP vs CD diet in an open label, crossover design aiming at body weight stability. The CRHP/CD diets contained carbohydrate 30/50 energy per cent (E%), protein 30/17E% and fat 40/33E%, respectively. Participants underwent a meal test at the end of each diet period and glycaemic variables, lipid profiles, 24 h blood pressure and ectopic fat including liver and pancreatic fat content were assessed at baseline and at the end of each diet period. Data were collected at Copenhagen University Hospital, Bispebjerg and Copenhagen University Hospital, Herlev.
RESULTS: Twenty-eight participants completed the study. Fourteen participants carried out 6 weeks of the CRHP intervention followed by 6 weeks of the CD intervention, and 14 participants received the dietary interventions in the reverse order. Compared with a CD diet, a CRHP diet reduced the primary outcome of HbA (mean ± SEM: -6.2 ± 0.8 mmol/mol (-0.6 ± 0.1%) vs -0.75 ± 1.0 mmol/mol (-0.1 ± 0.1%); p < 0.001). Nine (out of 37) pre-specified secondary outcomes are reported in the present paper, of which five were significantly different between the diets, (p < 0.05); compared with a CD diet, a CRHP diet reduced the secondary outcomes (mean ± SEM or medians [interquartile range]) of fasting plasma glucose (-0.71 ± 0.20 mmol/l vs 0.03 ± 0.23 mmol/l; p < 0.05), postprandial plasma glucose AUC (9.58 ± 0.29 mmol/l × 240 min vs 11.89 ± 0.43 mmol/l × 240 min; p < 0.001) and net AUC (1.25 ± 0.20 mmol/l × 240 min vs 3.10 ± 0.25 mmol/l × 240 min; p < 0.001), hepatic fat content (-2.4% [-7.8% to -1.0%] vs 0.2% [-2.3% to 0.9%]; p < 0.01) and pancreatic fat content (-1.7% [-3.5% to 0.6%] vs 0.5% [-1.0% to 2.0%]; p < 0.05). Changes in other secondary outcomes, i.e. 24 h blood pressure and muscle-, visceral- or subcutaneous adipose tissue, did not differ between diets.
CONCLUSIONS/INTERPRETATION: A moderate macronutrient shift by substituting carbohydrates with protein and fat for 6 weeks reduced HbA and hepatic fat content in weight stable individuals with type 2 diabetes.
TRIAL REGISTRATION: ClinicalTrials.gov NCT02764021.
FUNDING: The study was funded by grants from Arla Food for Health; the Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen; the Department of Clinical Medicine, Aarhus University; the Department of Nutrition, Exercise and Sports, University of Copenhagen; and Copenhagen University Hospital, Bispebjerg.

First Authors:
Mads J Skytte

Correspondence Authors:
Mads J Skytte

All Authors:
Mads J Skytte,Amirsalar Samkani,Amy D Petersen,Mads N Thomsen,Arne Astrup,Elizaveta Chabanova,Jan Frystyk,Jens J Holst,Henrik S Thomsen,Sten Madsbad,Thomas M Larsen,Steen B Haugaard,Thure Krarup

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