等热量不同成分食物对初诊2型糖尿病患者血浆GLP-1、胰岛素及血糖的即时影响

Immediate effects of different components of meals with the same energy on the plasma GLP-1,insulin and blood glucose in the newly diagnosed type 2 diabetes patients

目的研究等热量不同成分食物对初诊2型糖尿病患者胰高血糖素样肽-1(GLP-1)、胰岛素(INS)及血糖(BG)水平的即时影响。方法选择年龄、性别、体质量指数(BMI)相匹配的受试者52名,随机分为4组,分别给予等热量的葡萄糖粉、馒头、鸡蛋白羹、黄油,作为糖粉组、馒头组、蛋白组、黄油组,每组13例。分别采用酶联免疫吸附试验、电化学发光法、葡萄糖氧化酶法检测各组受试者0、1、2及3 h的GLP-1、INS、BG水平。结果各组0 h GLP-1、INS、BG水平差异无统计学意义(P>0.05)。糖粉组和馒头组餐后各时间点INS、BG水平均高于蛋白组和黄油组(P<0.05),其中2 h的糖粉组INS、BG水平高于馒头组(P<0.05);餐后1 h馒头、糖粉组GLP-1达峰值,馒头组高于糖粉组;餐后2 h蛋白组GLP-1水平较其他组明显升高,餐后各时间点GLP-1水平差异均有统计学意义(P<0.05)。结论等热量情况下,碳水化合物可能优先促进GLP-1分泌,且高碳水化合物对GLP-1的促进作用可能优于单糖食物;另一方面,高蛋白食物对GLP-1的促进作用显著。

Objective To investigate the immediate effects of different components meals with the same energy on the plasma glucagon-like peptide-1 （GLP-1）, insulin （INS） and blood glucose （BG） in the newly diagnosed type 2 diabe-tes patients.Methods A total of 52 patients matched in the age, sex and body mass index （ BMI） were randomly di-vided into four groups and were given meals mainly consisted of glucose powder, steamed buns, protein and butter with the same energy, respectively.And they were defined as glucose powder group, steamed buns group, protein group and butter group with 13 patients in each group.The plasma GLP-1, INS and BG levels were measured by enzyme linked immunosorbent assay, electrochemical luminescence method and glucose oxidase method respectively before meal intake and at 1, 2, 3 h after meal intake.Results There was no significant difference among the fasting plasma GLP-1, INS and BG levels in the four groups.The GLP-1, INS and BG levels in the glucose powder group and steamed buns group were higher than those in other groups at different time（P〈0.05）.The INS and BG levels in the glucose powder group were higher than that in the steamed buns group at 2 h （P〈0.05）.The GLP-1 level in the steamed buns group was higher than that in the glucose powder group at 1 h after meal intake（P〈0.05）, and both of them reached to the peak.＆nbsp;The GLP-1 levels were significant different in the four groups at 2 h, and that in the protein group was the highest （ P〈0.05）.Conclusion The carbohydrates may promote the secretion of GLP-1 prior to protein and lipid.High carbohy-drate food may promote the secretion of GLP-1 superior to pure sugar food.On the other hand, the high protein food has the most significant effect on stimulating the secretion of GLP-1.