【摘要】 目的观察葡萄糖耐量(OGTT)前1天高脂低碳水化合物摄入(热量相同但碳水化合物摄入减少,脂肪摄入增加)对健康成人糖耐量的影响,从而进一步确定是否OGTT前1天高脂低碳水化合物(HF)摄入导致糖耐量减低(IGT)的误诊。方法30例男性健康成人随机分为两组(HF组和对照组)进行交叉试验;分别于OGTT前1天早、中、晚餐时摄入热量相同的HF或对照配餐;次日清晨行75 g OGTT;分别测定血糖、胰岛素、游离脂肪酸、甘油三酯及胆固醇浓度;2次OGTT间隔1周。结果OGTT前1天HF使糖负荷后30、60、120分钟血糖分别升高33%、51%及42%,胰岛素分泌指数(△I/△G)降低50%,空腹血浆游离脂肪酸(FFA)浓度上升100%,使30%健康成人被误诊为IGT。结论即使总热量摄入相同,OGTT前1天HF引起健康成人空腹血浆游离脂肪酸水平升高,抑制早期胰岛素分泌,引起糖负荷后血糖的升高,导致IGT的误诊。更多还原

【Abstract】 Objective To determine whether high fat and low carbohydrate intake(daily energy intake is isocaloric while carbohydrate intake is decreased and fat intake is increased) before oral glucose tolerance test(OGTT) impairs glucose tolerance in healthy subjects.Methods Thirty male volunteers were randomly divided into two groups,high fat and low carbohydrate group(HF group) and control group.They consumed high fat and low carbohydrate diet(HF,fat 65%,protein 15%,carbohydrate 20%) or control diet(fat 5%,protein 15%,carbohydrate 80%) in their breakfast,lunch and supper a day before OGTT in a cross-over design study with one-week interval between tests.Plasma glucose,insulin,free fatty acids,triglyceride and total cholesterol concentrations were measured after OGTT performed the next morning.Results Compared with control group,HF in three meals before OGTT significantly increased postload glucose concentrations 33%,51%,42% at 30,60,120 minutes,decreased insulinogenic index about 50%,accompanied with an increase in fasting plasma free fatty acids level about 100%.30% healthy adults were misdiagnosed as impaired glucose tolerance after HF in their three meals before OGTT.Conclusion Although total energy intake was isocaloric,HF in three meals before OGTT increased fasting plasma free fatty acids level,inhibited glucose-stimulated insulin release,decreased glucose tolerance in healthy adults,and led to misdiagnosis of IGT.更多还原