Theresa Kössler, Pavel Bobrov, Klaus Strassburger, Oliver Kuss, Oana-Patricia Zaharia, Yanislava Karusheva, Clara Möser, Kálmán Bódis, Volker Burkart, Michael Roden, Julia Szendroedi
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引用次数: 3
Abstract
Background: Application of mixed meal tolerance tests (MMTT) to measure beta-cell function in long-term studies is limited by modification of the commercial products occurring over time. This study assessed the intra-individual reliability of MMTTs and compared the effects of liquid meals differing in macronutrient composition on the estimation of beta-cell function in type 2 diabetes (T2DM).
Methods: To test the reliability of MMTTs, 10 people with T2DM (age 58 ± 11 years, body mass index 30.0 ± 4.9 kg/m2) received Boost® high Protein 20 g protein three times. For comparing different meals, another 10 persons with T2DM (58 ± 5 years, 31.9 ± 5.3 kg/m2) ingested either Boost® high Protein 20 g protein or the isocaloric Boost® high Protein 15 g protein containing 35% less protein and 18% more carbohydrates. C-peptide, insulin and glucose release were assessed from the incremental area under the concentration time curve (iAUC) and the intra- and inter-individual variation of these parameters from the coefficients of variations (CV).
Results: Repetitive ingestion of one meal revealed intra-individual CVs for the iAUCs of C-peptide, insulin and glucose, which were at least 3-times lower than the inter-individual variation of these parameters (18.2%, 19.7% and 18.9% vs. 74.2%, 70.5% and 207.7%) indicating a good reliability. Ingestion of two different meals resulted in comparable intra-individual CVs of the iAUCs of C-peptide and insulin (16.9%, 20.5%).
Conclusion: MMTTs provide reliable estimation of beta-cell function in people with T2DM. Furthermore, moderate differences in the protein and carbohydrate contents in a standardized liquid meal do not result in relevant changes of C-peptide and insulin responses.
背景:混合膳食耐受性试验(MMTT)在长期研究中测量β细胞功能的应用受到商业产品随时间变化的限制。本研究评估了mmtt的个体内可靠性，并比较了不同常量营养素组成的液体餐对2型糖尿病(T2DM)患者β细胞功能的影响。方法:为检验mmtt的可靠性，10例T2DM患者(年龄58±11岁，体重指数30.0±4.9 kg/m2)接受3次Boost®high Protein 20 g Protein。为了比较不同的膳食，另外10名T2DM患者(58±5岁，31.9±5.3 kg/m2)摄入Boost®高蛋白20克蛋白质或等热量Boost®高蛋白15克蛋白质，其中蛋白质减少35%，碳水化合物增加18%。通过浓度时间曲线下的增量面积(iAUC)评估c肽、胰岛素和葡萄糖的释放，通过变异系数(CV)评估这些参数的个体内和个体间变化。结果:重复进食一餐时，c肽、胰岛素和葡萄糖的iAUCs的个体内cv值比这些参数的个体间变异值(分别为18.2%、19.7%和18.9%，分别为74.2%、70.5%和207.7%)低至少3倍，具有良好的可靠性。摄入两种不同的食物导致c肽和胰岛素iAUCs的个体内cv相当(16.9%，20.5%)。结论:mmtt为T2DM患者提供了可靠的β细胞功能评估。此外，标准化液体餐中蛋白质和碳水化合物含量的适度差异不会导致c肽和胰岛素反应的相关变化。试验注册:Clinicaltrials.gov，标识号:NCT01055093。注册于2010年1月22日-追溯注册，https://www.clinicaltrials.gov/ct2/show/study/NCT01055093。
期刊介绍：
Nutrition & Metabolism publishes studies with a clear focus on nutrition and metabolism with applications ranging from nutrition needs, exercise physiology, clinical and population studies, as well as the underlying mechanisms in these aspects.
The areas of interest for Nutrition & Metabolism encompass studies in molecular nutrition in the context of obesity, diabetes, lipedemias, metabolic syndrome and exercise physiology. Manuscripts related to molecular, cellular and human metabolism, nutrient sensing and nutrient–gene interactions are also in interest, as are submissions that have employed new and innovative strategies like metabolomics/lipidomics or other omic-based biomarkers to predict nutritional status and metabolic diseases.
Key areas we wish to encourage submissions from include:
-how diet and specific nutrients interact with genes, proteins or metabolites to influence metabolic phenotypes and disease outcomes;
-the role of epigenetic factors and the microbiome in the pathogenesis of metabolic diseases and their influence on metabolic responses to diet and food components;
-how diet and other environmental factors affect epigenetics and microbiota; the extent to which genetic and nongenetic factors modify personal metabolic responses to diet and food compositions and the mechanisms involved;
-how specific biologic networks and nutrient sensing mechanisms attribute to metabolic variability.
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