大米不同烹调方法对健康人餐后血糖和胰岛素分泌的影响

Effects of different cookery methods of rice on postprandial glucose and insulin response in healthy subjects

目的观察大米粥和大米饭对健康人餐后血糖和胰岛素分泌应答的影响。方法30名40岁以下，糖耐量、体重指数（BMI）、血压、肝肾功能正常，没有糖尿病家族史的健康人，早餐给予进食等量大米[体重（kg）×25kcal×60％×1／5]烹调成的大米粥或大米饭，并以等能量的葡萄糖作对照，观察0、30、60、120和180min血糖、胰岛素和C肽变化情况。结果无论进食大米饭、大米粥还是葡萄糖，餐后血糖都在正常范围。三种饮食120min血糖曲线下面积（AUC）没有差异；进食大米饭后餐后血糖最大波动值[（2．35±0．67）mmol／L]明显低于大米粥[（3．01±0．87）mmol／L，P〈0．05]和葡萄糖[（4．13±1．50）mmo]／L，P〈0．05]。进食大米饭后30min的胰岛素[（19．3±8．6）vs（26．7±13．0），（26．8±10．8）mU／L，均P〈0．05]、C肽明显低于进食大米粥和葡萄糖[（1．25±0．36）vs（1．70±0．46），（1．80±0．51）nmol／L，P〈0．05]；进食大米饭后120min和180min胰岛素高于其他两种饮食；进食大米饭餐后胰岛素最大波动值[（19．7±6．8）mU／L]明显低于大米粥[（27．6±13．1）mU／L，P〈0．05]和葡萄糖[（29．9±12．2）mU／L，P〈0．05]。结论健康人进食等量大米煮成的大米粥餐后血糖波动比进食大米饭更大，早期胰岛素分泌增加，餐后胰岛素波动增大。

Objective To explore effects of 2 different cuisines for rice （cooked rice and congee） on postprandial glucose and insulin response in healthy subjects. Methods Thirty healthy subjects aged less than 40 years with normal glucose tolerance, normal body mass index （ BMI）, normal blood pressure and negative diabetic family history were recruited. They were given cooked rice or congee made from isocaloric rice [ body weight（kg） ×25 kcal×60% × 1/5] and isocaloric glucose during breakfast or 3 experimental days. Blood samples were collected at 0, 30,60,120 and 180 min for detecting plasma glucose,insulin and C-peptide. Results Area under curve （AUC） of glucose at 120 rain was comparable among 3 diet groups. The maximal fluctuant value of glucose was significantly lower in case of cooked rice [ （2.35-±0.67） mmol/L] than those in congee [ （3.01 ±0.87） mmol/L,P〈0.05 ] and isocaloric glucose [ （4. 13 ± 1.50） retool/L, P〈 0.05 ]. At 30 rain, values of plasma iusulin in the subjects taking cooked rice, congee and glucose were（ 19.3 ±8.6, 26.7± 13.0, 26.8± 10.8 ）mU/L, respectively and the respective values of C-peptide were （ 1.25±0.36,1.70±0.46,1.80±0.51 ） nmol/L. The values of both insulin and C-peptide in case of cooked rice were significantly lower as compared with those in case of congee and glucose（P〈0.05）. At 120 min and 180 min, plasma insulin was higher in case of cooked rice than those in case of congee and glucose （ both P〈 0.05）. During the whole test,the maximal fluctuant value of insulin was significantly lower in case of cooked rice [ （19.7±6.8） mU/L] than those in case of congee [ （27.6± 13.1 ） mU/L, P〈0. 05 ] and glucose [ （29.9 ± 12.2 ） mU/L,P〈0.05 ]. Conclusion Congee stimulates more marked early insulin secretion than cooked rice in healthy subjects. Postprandial fluctuations of glucose and insulin are also marked after congee intake.