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首页> 外文期刊>The American Journal of Clinical Nutrition: Official Journal of the American Society for Clinical Nutrition >A low-glycemic index diet combined with exercise reduces insulin resistance, postprandial hyperinsulinemia, and glucose-dependent insulinotropic polypeptide responses in obese, prediabetic humans.
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A low-glycemic index diet combined with exercise reduces insulin resistance, postprandial hyperinsulinemia, and glucose-dependent insulinotropic polypeptide responses in obese, prediabetic humans.

机译：低血糖指数饮食与运动相结合可降低肥胖，糖尿病前期人群的胰岛素抵抗，餐后高胰岛素血症和葡萄糖依赖性促胰岛素多肽反应。

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BACKGROUND: The optimal lifestyle intervention that reverses diabetes risk factors is not known. OBJECTIVE: We examined the effect of a low-glycemic index (GI) diet and exercise intervention on glucose metabolism and insulin secretion in obese, prediabetic individuals. DESIGN: Twenty-two participants [mean +/- SEM age: 66 +/- 1 y; body mass index (in kg/m(2)): 34.4 +/- 0.8] underwent a 12-wk exercise-training intervention (1 h/d for 5 d/wk at approximately 85% of maximum heart rate) while randomly assigned to receive either a low-GI diet (LoGIX; 40 +/- 0.3 units) or a high-GI diet (HiGIX; 80 +/- 0.6 units). Body composition (measured by using dual-energy X-ray absorptiometry and computed tomography), insulin sensitivity (measured with a hyperinsulinemic euglycemic clamp with [6,6-(2)H(2)]-glucose), and oral glucose-induced insulin and incretin hormone secretion were examined. RESULTS: Both groups lost equal amounts of body weight (-8.8 +/- 0.9%) and adiposity and showed similar improvements in peripheral tissue (+76.2 +/- 14.9%) and hepatic insulin sensitivity (+27.1 +/- 7.1%) (all P < 0.05). However, oral glucose-induced insulin secretion was reduced only in the LoGIX group (6.59 +/- 0.86 nmol in the prestudy compared with 4.70 +/- 0.67 nmol in the poststudy, P < 0.05), which was a change related to the suppressed postprandial response of glucose-dependent insulinotropic polypeptide. When corrected for changes in beta cell glucose exposure, changes in insulin secretion were attenuated in the LoGIX group but became significantly elevated in the HiGIX group. CONCLUSIONS: Although lifestyle-induced weight loss improves insulin resistance in prediabetic individuals, postprandial hyperinsulinemia is reduced only when a low-GI diet is consumed. In contrast, a high-GI diet impairs pancreatic beta cell and intestinal K cell function despite significant weight loss. These findings highlight the important role of the gut in mediating the effects of a low-GI diet on type 2 diabetes risk reduction.
机译：背景：逆转糖尿病危险因素的最佳生活方式干预尚不清楚。目的：我们研究了低血糖指数（GI）饮食和运动干预对肥胖，糖尿病前期个体葡萄糖代谢和胰岛素分泌的影响。设计：22名参与者[平均+/- SEM年龄：66 +/- 1岁;体重指数（以kg / m（2）为单位：34.4 +/- 0.8]）进行了12周运动训练干预（以最大心率的85％大约1 d / w连续5 d / wk），接受低GI饮食（LoGIX; 40 +/- 0.3单位）或高GI饮食（HiGIX; 80 +/- 0.6单位）。身体成分（通过双能X射线吸收光度法和计算机断层扫描测量），胰岛素敏感性（通过高胰岛素正常血糖钳[6,6-（2）H（2）]-葡萄糖测量）和口服葡萄糖诱导的检查胰岛素和肠降血糖素激素的分泌。结果：两组患者的体重减轻了相等（-8.8 +/- 0.9％）和肥胖，并且外周组织表现出相似的改善（+76.2 +/- 14.9％）和肝胰岛素敏感性（+27.1 +/- 7.1％） （所有P <0.05）。但是，口服葡萄糖诱导的胰岛素分泌仅在LoGIX组中降低（研究前为6.59 +/- 0.86 nmol，研究后为4.70 +/- 0.67 nmol，P <0.05），这与抑制相关。葡萄糖依赖性促胰岛素多肽的餐后反应。当校正了β细胞葡萄糖暴露的变化后，LoGIX组的胰岛素分泌变化减弱，而HiGIX组的胰岛素分泌变化明显升高。结论：尽管生活方式引起的体重减轻改善了糖尿病前个体的胰岛素抵抗，但只有当食用低胃肠道饮食时，餐后高胰岛素血症才能减少。相反，尽管体重明显减轻，但高GI饮食会损害胰腺β细胞和肠K细胞功能。这些发现突出了肠道在介导低GI饮食对降低2型糖尿病风险中的重要作用。

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