Role of slowly digestible starch in diabetes risk factors in pre-diabetic people

缓慢消化淀粉在糖尿病前期人群糖尿病危险因素中的作用

• 批准号: 8372789
• 负责人: Eric Ravussin
• 金额: $ 43.31万
• 依托单位: LSU PENNINGTON BIOMEDICAL RESEARCH CTR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8372789
• 关键词: Acetates; Age; Amylases; Amylopectin; Amylose; Bacterial Genes; Butyrates; Caloric Restriction; Cartoons; Coenzyme A; Coenzyme A-Transferases; Consumption; Data; Desire for food; Development; Diabetes Mellitus; Diet; Dietary Intervention; Dietary Supplementation; Double-Blind Method; Eating; Endotoxemia; Energy Intake; Exercise; Fatty acid glycerol esters; Fermentation; Health; Hormones; Human; Impaired fasting glycaemia; Incidence; Individual; Inflammation; Ingestion; Insulin Resistance; Intake; Intervention; Large Intestine; Life Style; Lipids; Liver; Metabolic; Muscle; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Participant; Physical activity; Plasma; Population; Prediabetes syndrome; Production; Propionates; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Regimen; Risk; Risk Factors; Rodent; Role; Serum Markers; Starch; Structure of beta Cell of islet; Supplementation; Testing; Volatile Fatty Acids; Weight; Yogurt; blood glucose regulation; diabetes risk; diabetic; disorder risk; feeding; ghrelin; glucagon-like peptide 1; gut microbiota; high risk; impaired glucose tolerance; improved; inflammatory marker; insulin secretion; insulin sensitivity; microbial; microbial community; oxidation; response

DESCRIPTION (provided by applicant): In this double-blind randomized controlled trial, 80 individuals (35-65y) with pre-diabetes (IGT/IFG) will receive either a diet containing slow digestible starch (amylose; N=40) or "control" starch (amylopectin; N=40) for 3 months. Our data in rodents (supported by others) have shown that the ingestion of slow digestible starch: a) enhances the gut microbial profile; b) reduces metabolic endotoxemia; c) increases fermentation and production of butyrate & propionate; d) increases beneficial gut hormones such as GLP-1 and PYY; e) lowers the glycemic load and; f) suppresses appetite Therefore, we propose to feed a slowly digestible starch to simultaneously target several mechanisms known to be important in glucose homeostasis with emphasis on insulin sensitivity, fat oxidation and ectopic fat. We will test the hypothesis that improved composition of the gut microbiota with a daily intake of 45 g of amylose for 3 months in individuals with IGT and/or IFG will in turn improve risk factors for the development of T2DM such as: a) enhancement of insulin sensitivity (FSIGTT; Aim1); b) decrease appetite and food intake (Aim2); c) decrease ectopic fat depots (1H-MRS; Aim1); d) decrease inflammation (serum markers; Aim1) and; e) modify the composition of large intestine microbiota in a metabolically favorable way (Aim3). This dietary intervention approach (addition of slowly digestible starch in yogurts) may prove more tolerable than daily caloric restriction and exercise and therefore more practically applicable for the treatment of T2DM. PUBLIC HEALTH RELEVANCE: People with impaired glucose tolerance (IGT) suffer from insulin resistance and low grade inflammation and are at high risk of developing type 2 diabetes. Intensive lifestyle changes (reduced energy intake and increased physical activity) decrease the incidence of diabetes in people with IGT. However such lifestyle changes are difficult to maintain over the long-term and most people who lose weight regain it over subsequent years. The identification of a non-pharmacological intervention to improve insulin sensitivity in individuals could have a significant impact in an increasingly obese population. We therefore propose to study the effect of 3- month of dietary supplementation with 45-g of slowly digestible starch on risk factors for the development of type 2 diabetes in people with pre-diabetes (IGT). Preliminary data indicate that these starches may influence the gut microbial species which in turn may enhance insulin sensitivity and protect against the development of diabetes.

描述（由申请人提供）：在这项双盲随机对照试验中，80 名糖尿病前期 (IGT/IFG) 个体（35-65 岁）将接受含有缓慢消化淀粉（直链淀粉；N=40）的饮食或“对照”淀粉（支链淀粉；N=40）3个月。我们在啮齿动物中的数据（得到其他人的支持）表明，摄入缓慢消化的淀粉：a）增强肠道微生物特征； b) 减少代谢性内毒素血症； c) 增加丁酸盐和丙酸盐的发酵和产量； d) 增加有益的肠道激素，例如 GLP-1 和 PYY； e) 降低血糖负荷； f) 抑制食欲因此，我们建议饲喂缓慢消化的淀粉，以同时针对已知对葡萄糖稳态很重要的几种机制，重点是胰岛素敏感性、脂肪氧化和异位脂肪。我们将检验以下假设：对于 IGT 和/或 IFG 患者，每日摄入 45 克直链淀粉，持续 3 个月，可改善肠道微生物群的组成，进而改善发生 T2DM 的危险因素，例如：a) 增强胰岛素敏感性（FSIGTT；目标1）； b) 降低食欲和食物摄入量（目标2）； c) 减少异位脂肪库（1H-MRS；目标1）； d) 减少炎症（血清标志物；目标1）； e) 以代谢有利的方式改变大肠微生物群的组成（目标3）。这种饮食干预方法（在酸奶中添加缓慢消化的淀粉）可能比每日热量限制和运动更容易耐​​受，因此更适用于治疗 T2DM。 公众健康相关性：糖耐量受损 (IGT) 患者患有胰岛素抵抗和轻度炎症，并且患 2 型糖尿病的风险很高。强烈的生活方式改变（减少能量摄入和增加体力活动）可降低 IGT 患者的糖尿病发病率。然而，这种生活方式的改变很难长期维持，大多数减肥者在随后的几年里都会反弹。确定提高个体胰岛素敏感性的非药物干预措施可能会对日益肥胖的人群产生重大影响。因此，我们建议研究 3 个月膳食补充剂 45 克缓慢消化淀粉对糖尿病前期 (IGT) 患者发展为 2 型糖尿病的危险因素的影响。初步数据表明，这些淀粉可能会影响肠道微生物种类，进而可能增强胰岛素敏感性并预防糖尿病的发生。