不同成分营养餐对肠促胰岛素分泌及胰岛功能的影响

摘要

Objective To explore the effect of meals with different nutrient contents on incretin and islet function by testing on subjects with normal sugar tolerance. Methods We enrolled 15 healthy volunteers from Hebei General Hospital in 2010. In the self-control study,we conducted a one-week dietary elution by standard meals,and the subjects were given one of three kinds of meals,including high carbohydrate( HC),high protein( HP) and high fat( HF) meals. Then the subjects received one-week dietary elution by standard meals again,after which the test was undertaken again by providing subjects with one of the three kinds of meal. Blood glucose,insulin,GIP and GLP-1 levels were tested 0,30,60,120,180 and 240 minutes before and after the meals. Results There was interaction effect in blood glucose,insulin,GIP and GLP-1 among different time points and among different meal groups after meals ( P <0. 05 ). Three different meal groups were significantly different in AUCGlu 30 min,AUCGlu 240 min,AUCIns 30 min,AUCIns 240 min,AUCGIP 30 min,AUCGIP 240 min,AUCGLP-1 30 min,AUCGLP-1 240 min after meals(P<0. 05),HC was higher than HP and HF in AUCGlu 30 min,AUCGlu 240 min,AUCIns 30 min,AUCIns 240 min,AUCGIP 30 min,AUCGIP 240 min,AUCGLP-1 30 min,AUCGLP-1 240 min,and HP was higher than HF in AUCIns 30 min and AUCGIP 30 min(P<0. 05). Different meals were significantly different inΔI30/ΔG30 and AUCI/AUCG (P<0. 05),HP was higher than HC and HF in ΔI30/ΔG30,and HF was lower than HC and HP in AUCI/AUCG(P<0. 05). For HC,AUCIns 30 min was positively correlated with AUCGIP 30 min and AUCGLP-1 30 min(r=0. 476,0. 535;P<0. 05). For HC,AUCGLP-1 30 min was positively correlated with AUCGlu 30 min(r=0. 517,P<0. 05). For HP,AUCIns 30 min was positively correlated with AUCGIP 30 min(r =0. 433,P <0. 05). Conclusion meals with different nutrient contents have different influences on the secretion of GIP and GLP-1 and the change of islet function;HC meal can significantly promote the secretion of GIP,GLP-1 and insulin;HP meal can notably promote the early secretion of GIP and insulin and significantly increase the index of β cell function.%目的：通过给予糖耐量正常受试者不同成分营养餐，探讨其对肠促胰岛素、胰岛β细胞功能的影响。方法河北省人民医院于2010年招募15例健康志愿者，采用自身对照研究，受试者首先食用标准饮食洗脱1周，于试验当日接受高碳水化合物饮食（ HC）、高蛋白饮食（ HP）、高脂肪饮食（ HF）之一作为早餐摄入，然后再采用标准饮食洗脱1周，重复试验过程，分别进食3种不同的营养餐。测定进餐后0、30、60、120、180、240 min血糖、胰岛素、抑胃多肽（ GIP）和胰高血糖素样肽1（ GLP-1）水平。结果受试者进食3种营养餐后血糖、胰岛素、GIP、GLP-1时间与组间对其的影响均存在交互作用（ P<0.05）。受试者进食3种营养餐后AUC血糖30 min、AUC血糖240 min、AUC胰岛素30 min、AUC胰岛素240 min、AUCGIP 30 min、AUCGIP 240 min、AUCGLP-130 min、AUCGLP-1240 min比较，差异均有统计学意义（ P <0.05），其中 HC AUC血糖30 min、AUC血糖240 min、AUC胰岛素30 min、AUC胰岛素240 min、AUCGIP 30 min、AUCGIP 240 min、AUCGLP-130 min、AUCGLP-1240 min均高于HP和HF，HP AUC胰岛素30 min、AUCGIP 30 min高于HF，差异均有统计学意义（P<0.05）。不同营养餐ΔI30/ΔG30、AUCI/AUCG 比较，差异有统计学意义（P<0.05），其中HPΔI30/ΔG30高于HC、HF，HF AUCI/AUCG 低于HC、HP，差异均有统计学意义（ P<0.05）。HC AUC胰岛素30 min与AUCGIP 30 min、AUCGLP-130 min呈正相关（r=0.476、0.535，P<0.05）。HC AUCGLP-130 min与AUC血糖30 min呈正相关（r=0.517，P<0.05）。HP AUC胰岛素30 min与AUCGIP 30 min呈正相关（r=0.433，P<0.05）。结论不同成分营养餐均可影响GIP、GLP-1分泌及胰岛功能变化；HC促进GIP、GLP-1以及胰岛素分泌作用最明显；HP可明显促进早期GIP、胰岛素的分泌，胰岛β细胞功能指数也明显增高。