农村居民空腹血糖与餐后血糖检测对照研究

目的:探讨餐后1 h血糖与空腹血糖的相关性及餐后1 h血糖的诊断价值。方法:随机抽取健康体检的农村成年居民222名,除5人外,其中的217人为对照组,61例2型糖尿病患者为观察组,测定空腹血糖与早餐后1 h的血糖。结果:222名农村成年居民中有5人空腹血糖升高,其中2人为糖尿病人,3人为空腹血糖受损,其余217人为健康人。糖尿病组餐后1 h血糖升至9.70±1.95 mmol/L,与空腹血糖呈正相关。结论:餐后1 h血糖可作为糖尿病的诊断指标。     

Arabinoxylan fiber, a byproduct of wheat flour processing, reduces the postprandial glucose response in normoglycemic subjects

BACKGROUND: Arabinoxylan (AX) is the major component of dietary fiber in the cereal grains that make up a large proportion of our diet. However, the physiologic effect of AX is unknown. OBJECTIVE: The objective of this study was to determine whether AX improves postprandial glucose and insulin responses in healthy humans. DESIGN: AX-rich fiber was extracted from the byproduct of wheat-flour processing. Three isoenergic breakfasts, comprising bread, margarine, and jam, had 75 g available carbohydrate, 10 g protein, and 14 g fat and contained 0, 6, and 12 g AX-rich fiber, respectively. Fourteen healthy subjects consumed the 3 breakfast meals in random order on 3 mornings >/=3 d apart after an overnight fast. Blood was taken from the subjects at regular intervals over 2 h and was analyzed for glucose and insulin. The palatability of bread containing AX-rich fiber was compared with that of a control bread. RESULTS: Compared with the control meal containing 0 g AX-rich fiber, the peak postprandial glucose concentration after meals containing 6 and 12 g AX-rich fiber was significantly lower (6. 3 +/- 1.3 compared with 7.2 +/- 1.0 mmol/L, P < 0.01; 5.9 +/- 0.9 compared with 7.2 +/- 1.0 mmol/L, P < 0.001, respectively). The incremental area under the curve (IAUC) for glucose was 20.2% (95% CI: 5.8%, 34.7%; P < 0.01) and 41.4% (25.9%, 56.8%; P < 0.001) lower, whereas IAUC for insulin was 17.0% (2.0%, 32.1%; P < 0.05) and 32. 7% (18.8%, 46.6%; P < 0.001) lower, respectively. Bread containing AX-rich fiber was as pala as 50% whole-wheat bread when evaluated with sensory analysis by 30 volunteers. CONCLUSIONS: Postprandial glucose and insulin responses were improved by ingestion of AX-rich fiber. Further research is required to determine whether AX-rich fiber is of benefit to people with type 2 diabetes.     

Impact of sugar beet pectin and polydextrose on fasting and postprandial glycemia and fasting concentrations of serum total and lipoprotein lipids in middle-aged subjects with abnormal glucose metabolism

OBJECTIVE: To examine the effects of sugar beet pectin (SBP) and polydextrose (PDX) on fasting plasma glucose concentration, serum lipid profile and postprandial glycemia in middle-aged subjects with abnormal glucose metabolism. DESIGN: A placebo-controlled, randomized, parallel double-blinded study. SUBJECTS AND SETTING: Subjects were recruited via newspaper announcements. Seventy subjects were recruited of which 66 completed the study. INTERVENTION: The intervention period lasted for 12 weeks during which the subjects consumed a drink enriched with either SBP (n=22) or PDX (n=22) or without fiber enrichment (control group, n=22). The daily dose of the drinks was 4 dl. The subjects were also given nutrition counseling. Postprandial glycemia was examined in 24 subjects (n=8 in each group) at 0 and 12 weeks after a standardized breakfast. RESULTS: Fasting plasma glucose concentration did not change in the SBP and PDX groups, whereas it increased in the control group (P=0.007). On the contrary, the glycosylated hemoglobin A1(c) increased marginally but significantly (P< or =0.05) in the intervention groups without a change in the control group. In postprandial glycemia, no differences between the groups were found. In both the SBP and PDX groups, fasting serum High-density lipoprotein (HDL)-cholesterol concentration increased (P< or =0.05) without a change in the control group. Total to HDL-cholesterol ratio decreased in all groups (P< or =0.05). CONCLUSIONS: It was found that SBP and PDX do not have positive effects on fasting or postprandial plasma glucose concentrations or serum lipid profile in subjects with abnormal glucose metabolism.     

Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects

BACKGROUND: Previous studies of patients with type 2 diabetes showed that cinnamon lowers fasting serum glucose, triacylglycerol, and LDL- and total cholesterol concentrations. OBJECTIVE: We aimed to study the effect of cinnamon on the rate of gastric emptying, the postprandial blood glucose response, and satiety in healthy subjects. DESIGN: The gastric emptying rate (GER) was measured by using standardized real-time ultrasonography. Fourteen healthy subjects were assessed by using a crossover trial. The subjects were examined after an 8-h fast if they had normal fasting blood glucose concentrations. GER was calculated as the percentage change in the antral cross-sectional area 15-90 min after ingestion of 300 g rice pudding (GER1) or 300 g rice pudding and 6 g cinnamon (GER2). RESULTS: The median value of GER1 was 37%, and that of GER2 was 34.5%. The addition of cinnamon to the rice pudding significantly delayed gastric emptying and lowered the postprandial glucose response (P < 0.05 for both). The reduction in the postprandial blood glucose concentration was much more noticeable and pronounced than was the lowering of the GER. The effect of cinnamon on satiety was not significant. CONCLUSIONS: The intake of 6 g cinnamon with rice pudding reduces postprandial blood glucose and delays gastric emptying without affecting satiety. Inclusion of cinnamon in the diet lowers the postprandial glucose response, a change that is at least partially explained by a delayed GER.     

Folic acid treatment reduces elevated plasma levels of asymmetric dimethylarginine in hyperhomocysteinaemic subjects

Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase, has been suggested to be a novel risk factor for endothelial dysfunction. It has previously been reported that hyperhomocysteinaemia may be associated with impaired endothelium-dependent vasodilation and reduced plasma level of NO-derived endproducts (NOx). In the present study, plasma levels of arginine and ADMA were measured in twenty-one healthy control subjects, and in twenty-one hyperhomocysteinaemic subjects before and after 6 weeks and 12 months of folic acid supplementation, and compared with previously measured plasma NOx values in the hyperhomocysteinaemic subjects. Compared with control subjects, hyperhomocysteinaemic subjects had higher plasma levels of arginine and ADMA. More importantly, folic acid therapy significantly reduced plasma levels of arginine and ADMA. Furthermore, plasma levels of arginine and ADMA were positively correlated with plasma homocysteine levels and negatively correlated with plasma folate, as well as negatively correlated with plasma NOx. Our results suggest that ADMA may be a mediator of the atherogenic effects of homocysteine.     

Docosahexaenoic acid supplementation improves fasting and postprandial lipid profiles in hypertriglyceridemic men

BACKGROUND: The effects of docosahexaenoic acid (DHA) on the mean size and concentrations of VLDL, LDL, and HDL subclasses have not been previously studied. OBJECTIVE: We determined the effects of DHA supplementation on the concentrations of apoproteins; large, medium, and small VLDL, LDL, and HDL particles; and the mean diameters of these particles in fasting and postprandial plasma. DESIGN: Hypertriglyceridemic men aged 39-66 y (n = 34) participated in a double-blind, randomized, placebo-controlled parallel study. They received no supplements for the first 8 d and received either 7.5 g DHA oil/d (3 g DHA/d) or olive oil (placebo) for the last 90 d. Lipoprotein particle diameters and concentrations were measured by nuclear magnetic resonance spectroscopy. RESULTS: DHA supplementation for 45 d significantly (P < 0.05) decreased concentrations of fasting triacylglycerol (24%), large VLDL (92%), and intermediate-density lipoproteins (53%) and the mean diameter of VLDL particles (11.1 nm). It elevated concentrations of LDL cholesterol (12.6%), small VLDL particles (133%), and large LDL particles (120%) and the mean diameter of LDL particles (0.6 nm) in fasting plasma. Similar changes were observed for area under the curve for postprandial samples (0-6 h); however, the number of small dense LDL particles decreased significantly (21%), and the change in LDL cholesterol was not significant. Continued supplementation with DHA beyond 45 d caused no further changes; placebo treatment altered none of the responses tested. CONCLUSION: DHA supplementation may improve cardiovascular health by lowering concentrations of triacylglycerols and small, dense LDL particles.     

Effects of changes in obesity and exercise on the development of diabetes and return to normal fasting plasma glucose levels at one-year follow-up in middle-aged subjects with impaired fasting glucose

Objectives  Borderline diabetes, a precursory condition of diabetes, is an important issue in the prevention of diabetes. The aim of the present study was to clarify the effects of one-year changes in obesity and exercise on the development of diabetes or return to normal fasting plasma glucose (FPG) levels among middle-aged people with impaired fasting glucose (IFG) at baseline. Methods  Among those who attended a basic health examination in 1997, we selected 1,620 subjects who showed impaired fasting glucose (FPG of 110 mg/dl or higher) and had complete data on height, weight and exercise. At the one-year follow-up (in 1998), 1,099 of those subjects attended a health examination; FPG, height, weight and exercise were evaluated for 731 subjects. Subjects were classified into the following three groups, on the basis of changes in FPG during the year between the two examinations: developing diabetes (DM), remaining IFG, and returning to normal (WNL). Results  Among those who were initially obese, there was a significant difference in the proportions of DM, IFG and WNL between those with and without improvement in obesity in the year preceding the follow-up (p<0.05). Those with improvement in obesity showed a significantly higher tendency to return to WNL than those without improvement in obesity. Multiple logistic regression analysis showed that those with improvement in obesity had a significantly higher odds ratio (2.17) to return to WNL (p=0.015). Among those who were initially not obese, there was no significant association between changes in obesity and developing DM or returning to WNL. No significant association was observed between changes in exercise and developing DM or returning to WNL. Conclusion  The present findings suggest that, among obese IFG subjects, improvement in obesity is associated with returning to normal plasma glucose. Weight control may be important for the normalization of borderline diabetes.     

Leucine, glucose, and energy metabolism after 3 days of fasting in healthy human subjects

Adaptations of leucine and glucose metabolism to 3 d of fasting were examined in six healthy young men by use of L-[1-13C]leucine and D[6,6-2H2]glucose as tracers. Leucine flux increased 31% and leucine oxidation increased 46% after 3 d of fasting compared with leucine flux and oxidation after an overnight fast. Glucose production rate declined 38% and resting metabolic rate decreased 8% during fasting. Plasma concentrations of testosterone, insulin, and triiodothyronine were reduced by fasting whereas plasma glucagon concentrations were increased. We conclude that there is increased proteolysis and oxidation of leucine on short-term fasting even though glucose production and energy expenditure decreased.     

Bivariate genetic analysis of fasting insulin and glucose levels

The main aim of this study was to estimate the relative influence of genes and environment on fasting insulin levels, which were considered a proxy of insulin resistance. Possible sex differences in genetic and environmental influences, and the origin of the covariance between fasting insulin and glucose were investigated. Subjects were 209 pairs of middle-aged twins, divided into 5 sex-by-zygosity groups. A general bivariate model and a reciprocal causation model including fasting insulin and glucose were used in the analyses. For both quantitative genetic models, a model specifying additive genetic and unique environmental factors, which were the same in males and females, showed the best fit to the data. Heritability estimates were modest and highly similar in both models: 20-25% of the variance in fasting insulin, and around 50% of the variance in fasting glucose levels could be attributed to genetic factors. The two models could not be discriminated on the basis of their fit to the data. A submodel of the general bivariate model suggested that the covariance between glucose and insulin has a unique environmental basis, whereas for the reciprocal causation model both causal paths were needed to explain the phenotypic correlation between insulin and glucose and estimates of the reciprocal paths were of opposite sign, an indication for the expected negative feedback loop.     

Arabinoxylan consumption decreases postprandial serum glucose, serum insulin and plasma total ghrelin response in subjects with impaired glucose tolerance

OBJECTIVE: Arabinoxylan (AX) consumption is associated with metabolic improvement during diabetes and with modulation of ghrelin, an orexigenic gut hormone. The effect of AX consumption on ghrelin secretion in disturbed metabolic states is unknown. Therefore, we investigated the postprandial responses to AX consumption of serum glucose, insulin and triglycerides and plasma total and acylated ghrelin in subjects with impaired glucose tolerance (IGT). DESIGN: Randomized, single-blind, controlled, crossover intervention trial. SUBJECTS: Seven female and four male adults with IGT, aged 55.5 years, and body mass index (BMI) 30.1 kg/m(2). INTERVENTION: Subjects received either placebo or 15 g AX supplement for 6 weeks with a 6-week washout period in-between. MAIN OUTCOME MEASUREMENTS: Postprandial responses of serum glucose, insulin and triglycerides, and plasma total and acylated ghrelin after a liquid meal challenge test (LMCT) measured at the beginning and at the end of the dietary intervention at -20, -5, 0, 15, 30, 45, 60, 90, 120, 150, 180, 210 and 240 min. RESULTS: After LMCT, AX consumption resulted in lower postprandial responses in serum glucose, insulin and triglycerides (P<0.05). Compared to placebo, total plasma ghrelin was also reduced by 42+/-8 pg/ml (P<0.001) after AX consumption with no difference in plasma acylated ghrelin. CONCLUSION: AX consumption improved postprandial metabolic responses after an LMCT in subjects with IGT and reduced total ghrelin response. However, acylated ghrelin responses were unchanged, suggesting that the acylated ghrelin-mediated orexigenic regulation is not improved as only total plasma ghrelin decreased.     

北京社区体检人群餐后与空腹血脂水平的比较分析及意义

目的:探讨非空腹血脂异常判定标准在北京社区人群中应用的可行性。方法:采用自身对照研究。中国中医科学院广安门医院检验科于2018年1至10月招募社区体检者839名（男性292名,女性547名）,年龄中位数（四分位间距）为60（54, 66）岁,同时检测空腹和标准餐后4 h血脂谱水平,采用配对 t检验或者配对非...     

Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose,insulin, triacylglycerol,and free fatty acid concentrations in subjects with impaired glucose tolerance

BACKGROUND: Reducing the glycemic load (GL) is considered beneficial for managing insulin resistance. The GL can be reduced either by reducing carbohydrate intake or by reducing the glycemic index (GI). OBJECTIVE: We studied whether these 2 dietary maneuvers have the same long-term effects on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid (FFA) concentrations in subjects with impaired glucose tolerance (IGT). DESIGN: Thirty-four subjects with IGT were randomly assigned to high-carbohydrate, high-GI (high-GI); high-carbohydrate, low-GI (low-GI); and low-carbohydrate, high-monounsaturated fatty acid (MUFA) diets for 4 mo. Plasma glucose, insulin, and FFAs were measured from 0800 to 1600 at baseline in response to high-GI meals (60% carbohydrate, GI = 61, GL = 63) and after 4 mo in response to meals representative of the study diet. RESULTS: Carbohydrate intake (% of energy), GI, and GL in the high-GI, low-GI, and MUFA groups (breakfast and lunch meals combined), respectively, were 60%, 61, and 63; 60%, 53, and 55; and 49%, 61, and 52. Compared with the change after 4 mo of the high-GI diet, both the low-GI and MUFA diets reduced 0-8-h mean plasma glucose concentrations by 0.35 mmol/L (P < 0.05). Mean plasma insulin was approximately 20% higher (P < 0.05) and FFAs approximately 12% lower (P < 0.05) after the low-GI diet than after the high-GI diet, with no significant effect of MUFA. Changes in 0-8-h mean plasma triacylglycerols in the 3 treatment groups differed significantly: -0.14, 0.04, and 0.18 mmol/L, respectively, with the high-GI, MUFA, and low-GI diets. CONCLUSIONS: In subjects with IGT, reducing the GI of the diet for 4 mo reduced postprandial plasma glucose by the same amount as did reducing carbohydrate intake. The 2 dietary maneuvers had different effects on postprandial plasma insulin, triacylglycerols, and FFAs.     

Supplementation of cheonggukjang and red ginseng cheonggukjang can improve plasma lipid profile and fasting blood glucose concentration in subjects with impaired fasting glucose

This study was conducted to investigate the plasma lipid profile and blood glucose-lowering effects of cheonggukjang (CH) and red ginseng CH (RGCH) in 45 subjects (men:women?=?27:18; mean age, 44.9?±?3.1 years) with impaired fasting glucose (IFG). Subjects were randomly divided into three groups: control (starch, 2?g/day), CH (20?g/day), and RGCH (20?g/day). Each volunteer received his or her daily doses for 8 weeks. The supplementation with CH and RGCH significantly decreased the plasma total cholesterol about 30.0?mg/mL and 37.7?mg/mL, respectively, compared to the initial value. The plasma low-density lipoprotein-cholesterol concentration was also significantly reduced by 29.66% and 23.42% in the CH and RGCH groups, respectively, compared to the initial value. The concentration of plasma non-high-density lipoprotein-cholesterol (107.9?mg/mL) was significantly lowered in the RGCH group compared to the initial value (139.1?mg/mL). The level of erythrocyte thiobarbituric acid-reactive substances was significantly lowered in the CH (6.5?nmol/mL) and RGCH (6.6?nmol/mL) groups compared to the initial value (7.9?nmol/mL and 8.0?nmol/mL, respectively). The ratio of apolipoprotein B and apolipoprotein A-1 concentrations (2.5) was significantly reduced in the CH group compared to the initial value (3.0). The concentration of fasting blood glucose (FBG) was significantly lower in the CH- and RGCH-supplemented groups compared to the initial value. These results suggest that CH and RGCH can lower the FBG concentration and improve the plasma lipid profile in subjects with IFG.     

新疆汉族和维吾尔族糖调节受损人群胰岛素分泌及其功能的比较研究

目的 比较新疆地区汉族和维吾尔(维)族人群空腹血糖受损(IFG)、糖耐量减低(IGT)及混合性糖调节受损(CGI,IFG/IGT)阶段胰岛素分泌及其功能.方法 2007-2008年在新疆部分地区采用多中心横断面调查(中国第三次糖尿病流行病学调查),共计2203名研究对象(汉族111 8人,维族1085人)行口服75 g葡萄糖耐量试验(OGTT),用胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗,胰岛β细胞功能指数(HOMA-β评估基础胰岛素分泌,OGTT中空腹和30 min胰岛素、血糖差值的比值(ΔI30/ΔG30)评价胰岛素早相分泌,ΔI30/ΔG30/HOMA-IR评估葡萄糖处置指数(DI).结果 腰围、体重指数、血脂水平、0及120 min胰岛素值在汉维两民族不同糖代谢组的差异有统计学意义.在糖调节正常(NGT)、IFG、CGI组,维族人群的腰围要显著高于汉族(P＜0.01).在NGT、IFG、IGT组,汉族人群的120 min血清胰岛素水平则显著高于维族(P＜0.01).汉族人群的HOMA-IR、HOMA-β在不同糖代谢组均显著高于维族(P＜0 01).ΔI30/ΔG30、DI在两民族不同糖代谢组间的差异无统计学意义.结论 汉族人群较维族在糖调节受损阶段有显著的胰岛素抵抗,同时存在胰岛β细胞代偿性分泌以维持血糖水平.     

Addition of glucose to an oral fat load reduces postprandial free fatty acids and prevents the postprandial increase in complement component 3

BACKGROUND: Elevated fasting plasma concentrations of complement component 3 (C3) are associated with elevated fasting and postprandial triacylglycerol concentrations, insulin resistance, obesity, and coronary artery disease. C3 is the central component of the complement system and the precursor of acylation-stimulating protein (ASP). Insulin and ASP are principal determinants of free fatty acid (FFA) trapping by adipose tissue. OBJECTIVE: Because controversy exists concerning postprandial changes in C3 and because meal composition may influence complement activation, we studied postprandial lipemia in relation to changes in plasma C3. DESIGN: After an overnight fast, 6 healthy men ( +/- SD age: 23 +/- 2 y) underwent 4 oral liquid challenges: fat (50 g/m(2) body surface), glucose (37.5 g/m(2)), fat and glucose (mixed test), and water (as a control test) in a random, crossover design. RESULTS: Plasma ASP concentrations did not change postprandially in any test. Changes in C3 concentration were observed only after the fat challenge: elevated concentrations occurred between 1 and 3 h, and a maximum increase of 11% occurred at 2 h (P = 0.05). Postprandial triacylglycerolemia did not differ significantly between the fat and mixed tests. The FFA response after the fat challenge was the highest of all the tests (P < 0.05 for all comparisons) and was accompanied by an increase in ketone bodies (maximum at 6 h); this increase did not occur after the mixed test, which suggests less hepatic FFA delivery. CONCLUSIONS: When glucose is added to an oral fat load, the postprandial FFA response is reduced, and the fat-specific increase in C3 is prevented. After ingestion of fat without glucose, the lack of insulin response may lead to C3-mediated peripheral FFA trapping, which probably serves as a backup system in case of insufficient or inefficient insulin-dependent FFA trapping.