急性果糖过量摄入对健康成人血浆胰岛素及脂肪因子水平的影响

Effect of acute fructose overdose on plasma insulin and adipokine levels in healthy adults

目的 观察急性果糖过量摄入对健康成人血中胰岛素、瘦素、脂联素及颗粒蛋白前体(progranulin,PGRN)水平的影响。方法 选取2023年5月于河北省人民医院被招募的健康成人受试者16例进行自身对照试验,先后分别给予75g果糖溶液及75g葡萄糖溶液,两次干预间给予1周洗脱期。测量隔夜空腹及服用果糖及葡萄糖后0.5、1.0、2.0、3.0h时血糖、胰岛素、C肽、瘦素、脂联素、PGRN、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、骨钙素、白细胞介素6 (interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)水平。结果 急性果糖及葡萄糖负荷后血糖、胰岛素及C肽水平均有不同程度的升高(P>0.05),并在30min时升高最为显著,且急性葡萄糖负荷后胰岛素升高程度远大于急性果糖负荷后,急性葡萄糖负荷后的3h血糖、胰岛素、C肽曲线下面积(area under curve,AUC)均明显高于急性果糖负荷后(P<0.01)。与0min时相比,急性果糖及葡萄糖负荷后瘦素、脂联素、PGRN、TC、TG、HDL-C、LDL-C、骨钙素、IL-6、CRP水平变化均无统计学意义(P>0.05)。且两次干预的瘦素、脂联素、PGRN、TC、TG、HDL-C、LDL-C、骨钙素、IL-6、CRP的3h AUC无统计学差异(P>0.05)。结论 急性果糖过量摄入可导致健康成人血糖及胰岛素水平升高,但对瘦素、脂联素、PGRN水平无显著影响。

Objective To observe the effects of acute fructose overdose on blood levels of insulin,leptin,adiponectin,and progranulin(PGRN)in healthy adults.Methods Sixteen healthy adults were included in an self-controlled case series study from Hebei General Hospital in May 2023 and were given 75g of fructose solution and 75g of glucose solution respectively,with a 1-week washout period between interventions.Blood glucose,insulin,C-peptide,leptin,adiponectin,PGRN,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),osteocalcin,leukocyte 6(IL-6),and C-reactive protein(CRP)were measured in the overnight fasting period and at 0.5,1.0,2.0,and 3.0h after fructose and glucose administration.Results Blood glucose,insulin and C-peptide levels increased to different degrees after acute fructose and glucose loading(P<0.05),and increased most significantly at 30min.The degree of insulin elevation was much greater after acute glucose loading than after acute fructose loading,and the 3-hour blood glucose,insulin,and C-peptide area under the curve(AUC)after acute glucose loading were all were significantly higher after acute fructose loading(P<0.01).There were no significant changes in the levels of leptin,adiponectin,PGRN,TC,TG,HDL-C,LDL-C,osteocalcin,IL-6,and CRP after acute fructose and glucose loading compared with those at 0 min(P>0.05).And there was no statistically significant difference in the 3h AUC of leptin,adiponectin,PGRN,TC,TG,HDL-C,LDL-C,osteocalcin,IL-6,and CRP between the two interventions(P>0.05).Conclusions Acute fructose overdose results in elevated blood glucose and insulin levels in healthy adults,but has no significant effect on leptin,adiponectin,or PGRN levels.