PDF(Pubmed)
Abstract：
Type 2 diabetes mellitus (T2DM) is a major global public health issue. Diet and physical exercise are modifiable factors that influence the glycaemic status of patients with T2DM. We aimed to investigate the acute effects of breakfast fruits meal sequence and postprandial exercise on the blood glucose level and dipeptidyl peptidase 4 (DPP4) activity among type 2 diabetes mellitus patients.
A randomized pilot study recruited patients with T2DM who attended two primary health care centres in Tasikmadu District, Karanganyar Regency, and Kartasura District, Sukoharjo Regency, Central Java, Indonesia, from July to October 2016. Eligible patients (4 men and 32 women) were randomly divided into four treatment groups. Venous blood samples were analyzed for fasting and one-hour postprandial blood glucose (FBG and 1 h PPG) levels and DPP4 activity. Blood glucose levels were measured using a routine hexokinase method, and serum DPP4 activity was determined spectrophotometrically after incubation with the Gly-Pro-p-nitroanilide substrate.
Fruits last meal decreased FBG level whilst fruits first meal did not significantly decrease 1 h PPG level. Both treatments had no acute effects on DPP4 activity but the addition of postprandial exercise helped lower DPP4 activity. Fruit last and first meals showed significant opposite effects on mean changes of FBG level (p < 0.05).
This preliminary report of fruits meal sequence is potentially involved in acute regulation of blood glucose levels and that it might be independent of DPP4 activity in Indonesian patients with T2DM. Moreover, postprandial exercise may be an important intervention for T2DM through the mediation of DPP4 but has no acute effects on the regulation of blood glucose levels. Further studies are required to investigate whether or not different types of fruits and longer treatment intervals can affect blood glucose levels and DPP4 activity differently. This study also gives an insight into the feasibility of conducting food order modification with or without the combination of postprandial exercise in a primary health setting for our next studies.
A randomized pilot study recruited patients with T2DM who attended two primary health care centres in Tasikmadu District, Karanganyar Regency, and Kartasura District, Sukoharjo Regency, Central Java, Indonesia, from July to October 2016. Eligible patients (4 men and 32 women) were randomly divided into four treatment groups. Venous blood samples were analyzed for fasting and one-hour postprandial blood glucose (FBG and 1 h PPG) levels and DPP4 activity. Blood glucose levels were measured using a routine hexokinase method, and serum DPP4 activity was determined spectrophotometrically after incubation with the Gly-Pro-p-nitroanilide substrate.
Fruits last meal decreased FBG level whilst fruits first meal did not significantly decrease 1 h PPG level. Both treatments had no acute effects on DPP4 activity but the addition of postprandial exercise helped lower DPP4 activity. Fruit last and first meals showed significant opposite effects on mean changes of FBG level (p < 0.05).
This preliminary report of fruits meal sequence is potentially involved in acute regulation of blood glucose levels and that it might be independent of DPP4 activity in Indonesian patients with T2DM. Moreover, postprandial exercise may be an important intervention for T2DM through the mediation of DPP4 but has no acute effects on the regulation of blood glucose levels. Further studies are required to investigate whether or not different types of fruits and longer treatment intervals can affect blood glucose levels and DPP4 activity differently. This study also gives an insight into the feasibility of conducting food order modification with or without the combination of postprandial exercise in a primary health setting for our next studies.
摘要：
2型糖尿病(T2DM)是全球性的重大公共卫生问题。饮食和体育锻炼是影响T2DM患者血糖状态的可改变因素。我们旨在研究早餐水果餐顺序和餐后运动对2型糖尿病患者血糖水平和二肽基肽酶4（DPP4）活性的急性影响。
一项随机试点研究招募了在Tasikmadu区两个初级卫生保健中心就诊的T2DM患者，KaranganyarRegency,和Kartasura区,SukoharjoRegency,中爪哇，印度尼西亚,2016年7月至10月。符合条件的患者（4名男性和32名女性）被随机分为四个治疗组。分析静脉血样本的空腹和餐后一小时血糖（FBG和1hPPG）水平以及DPP4活性。使用常规己糖激酶方法测量血糖水平，与Gly-Pro-对硝基苯胺底物孵育后，用分光光度法测定血清DPP4活性。
水果最后一餐降低了FBG水平，而水果第一餐没有显着降低1hPPG水平。两种治疗方法对DPP4活性均无急性影响，但餐后运动有助于降低DPP4活性。最后一餐和第一餐对FBG水平的平均变化表现出显着相反的影响（p<0.05）。
这份关于水果膳食序列的初步报告可能与血糖水平的急性调节有关，并且它可能与印度尼西亚T2DM患者的DPP4活性无关。此外，餐后运动可能是通过DPP4介导的T2DM的重要干预措施，但对血糖水平的调节没有急性影响。需要进一步的研究来研究不同类型的水果和更长的治疗间隔是否可以不同地影响血糖水平和DPP4活性。这项研究还为我们的下一步研究提供了在初级健康环境中进行或不进行餐后运动相结合的食物顺序修改的可行性。
一项随机试点研究招募了在Tasikmadu区两个初级卫生保健中心就诊的T2DM患者，KaranganyarRegency,和Kartasura区,SukoharjoRegency,中爪哇，印度尼西亚,2016年7月至10月。符合条件的患者（4名男性和32名女性）被随机分为四个治疗组。分析静脉血样本的空腹和餐后一小时血糖（FBG和1hPPG）水平以及DPP4活性。使用常规己糖激酶方法测量血糖水平，与Gly-Pro-对硝基苯胺底物孵育后，用分光光度法测定血清DPP4活性。
水果最后一餐降低了FBG水平，而水果第一餐没有显着降低1hPPG水平。两种治疗方法对DPP4活性均无急性影响，但餐后运动有助于降低DPP4活性。最后一餐和第一餐对FBG水平的平均变化表现出显着相反的影响（p<0.05）。
这份关于水果膳食序列的初步报告可能与血糖水平的急性调节有关，并且它可能与印度尼西亚T2DM患者的DPP4活性无关。此外，餐后运动可能是通过DPP4介导的T2DM的重要干预措施，但对血糖水平的调节没有急性影响。需要进一步的研究来研究不同类型的水果和更长的治疗间隔是否可以不同地影响血糖水平和DPP4活性。这项研究还为我们的下一步研究提供了在初级健康环境中进行或不进行餐后运动相结合的食物顺序修改的可行性。
