中链甘油三酯干预对2型糖尿病血脂和血浆游离脂肪酸的影响

目的探讨中链甘油三酯(MCT)干预对2型糖尿病(T2DM)患者体重、血脂和血浆游离脂肪酸的影响。方法以长链甘油三酯(LCT)为对照,将所有T2DM患者分为MCT组、MCT/LCT组和LCT组,在控制总能量和脂肪摄入量的基础上,3组分别连续食用100%MCT油、50%MCT油 50%LCT油和100%LCT油12周。在0、6和12周时检测血浆总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)和载脂蛋白B(ApoB)浓度以及血浆游离脂肪酸浓度。计算体质指数(BMI)、LDL/HDL、ApoA1/ApoB、总游离脂肪酸(TFFA)、长链饱和脂肪酸(LCSFA)和不饱和脂肪酸(USFA)浓度。结果在6和12周时,MCT和MCT/LCT组的体重和BMI均较LCT组低(P<0.05)。在12周时MCT/LCT组的TC水平较LCT组低(P<0.05)。与实验前相比,MCT/LCT组6和12周时的LDL-C水平均显著下降(P<0.05);与6周时相比,MCT组12周时的LDL-C水平显著下降(P<0.05)。12周时LCT组的HDL-C水平较MCT组高(P<0.05)。与MCT组相比,LCT组的LCSFA水平在6周时显著升高(P<0.05)。3组的TFFA和USFA水平差异无显著性。结论在控制总能量和脂肪摄入量的基础上,用MCT取代100%或50%的膳食油脂,患者的BMI和血脂谱得到改善,而血浆游离脂肪酸无明显变化。

Effect of Medium Chain Triglyceride on Blood Lipids and Free Fatty Acid in Patients with Type 2 Diabetes

Objective To observe the effect of medium chain triglyceride(MCT)on body weight,blood lipids,and free fatty acids in patients with type 2 diabetes mellitus.Methods With total energy and fat consumption controlled,patients in MCT group were given 100% MCT oil,MCT/long chain triglyceride(LCT)group were given 50% MCT oil 50% LCT oil,and LCT group were given 100% LCT oil.All patients were asked to take the test oil every day for 12 weeks.Body height and body weight,total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),apoprotein A1(ApoA1),apoprotein B(ApoB)and free fatty acids were measured at 0,6,and 12 weeks.Then body mass index(BMI),LDL/HDL,ApoA1/ApoB,long chain saturated fatty acid(LCSFA),unsaturated fatty acid(USFA),and total free fatty acid(TFFA)were analysized.Results Compared with LCT group,body weight and BMI in MCT group and MCT/LCT group at 6 and 12 weeks significantly decreased(P<0.05).Compared with LCT group,blood TC in MCT/LCT group at 12 weeks was significantly lower(P<0.05).Compared with 0 week,blood LDL-C of 6 and 12 weeks in MCT/LCT group were significantly lower(P<0.05).Compared with 6 weeks,blood LDL-C of 12 weeks in MCT group was significantly lower(P<0.05).Compared with MCT group,blood HDL-C in LCT group at 12 weeks was significantly higher(P<0.05).LCSFA in LCT group step up at 6 weeks and was significantly higher than that in MCT group(P<0.05).No significant differences of TFFA and USFA were found among three groups.Conclusion When the total energy and fat consumption is controlled,full or partial replacement of the daily diet oil with MCT may improve BMI and blood lipids without obvious changes of blood free fatty acids.