背景:间歇性禁食(IF)是一种常用的饮食习惯,在不受限制的饮食消耗和节制热量摄入之间交替使用。IF减少热量摄入,同时代谢从葡萄糖的利用转变为脂肪酸和酮,并导致肥胖和随后的胰岛素抵抗的减少。因此,据推测,IF方案可以改善肥胖和超重个体的身体成分.
目的:评估IF对肥胖和超重2型糖尿病(T2D)患者脂质生物动力学的影响。
方法:从专科医院的糖尿病门诊招募了30名超重或肥胖的T2D患者,曼苏拉大学。在斋月期间,患者接受限时禁食16小时(从黎明到日落)。在斋月禁食之前和之后3周测量参与者的人体测量数据。空腹血糖(FPG),HbA1c,血脂谱,瘦素,分别于斋月前1周和斋月后3周测定β羟丁酸(βHB)和超敏CRP水平。
结果:招募了30名糖尿病患者,平均年龄为54.3±7.2岁。24(80%)为女性。27例(90%)被诊断为肥胖。中位糖尿病病程为10年。研究表明,禁食后体重(BW)有统计学上的显着下降,身体质量指数(BMI),腰围(WC)和臀围(HC)。空腹低密度脂蛋白(LDL-C)有统计学意义的下降,总胆固醇(TC),还有瘦素.该研究还显示了空腹后高密度脂蛋白(HDL-C)和βHB的统计学显着增加。空腹后HbA1c水平无明显变化,FPG,甘油三酯(TG)或高敏CRP。空腹瘦素与空腹体重呈正相关,BMI,WC,HC。空腹后βHB与空腹后TG呈正相关,HbA1c,和LDL-C瘦素水平变化(空腹前与空腹后)与LDL-C水平变化呈正相关。
结论:IF降低了瘦素水平,增加了β-羟丁酸水平。IF是减轻肥胖和超重T2D患者体重和内脏脂肪以及改善血脂状况的有效工具。
BACKGROUND: Intermittent fasting (IF) is a commonly used dietary practice that alternates between periods of unrestricted dietary consumption and abstinence from caloric intake. IF reduces caloric intake along with metabolic switch from utilization of glucose to fatty acids and ketones and resulting in reduction in adiposity and subsequently insulin resistance. Thus, it has been hypothesized that IF regimens can improve body composition in obese and overweight individuals.
OBJECTIVE: To assess the effect of IF on lipid biokinetics in obese and overweight patients with type 2 diabetes (T2D).
METHODS: Thirty overweight or obese T2D patients were recruited from the diabetes outpatient clinics at the Specialized Medical Hospital, Mansoura University. Patients were subjected to time restricted fasting for 16 h (from dawn to sunset) during Ramadan. Anthropometric data were measured for participants before and 3 weeks after Ramadan fasting. Fasting plasma glucose (FPG), HbA1c, lipid profile, leptin, beta hydroxybutyrate (βHB) and high sensitive CRP levels were measured 1 week before and 3 weeks after Ramadan fasting.
RESULTS: 30 diabetic patients were recruited with a mean age of 54.3 ± 7.2 years. 24 (80%) were females. Obesity was diagnosed in 27 cases (90%). The median diabetes duration was 10 years. The study showed a statistically significant decrease in post-fasting body weight (BW), Body mass index (BMI), waist circumference (WC) & hip circumference (HC). There was a statistically significant decrease of post-fasting low density lipoprotein (LDL-C), Total cholesterol (TC), and leptin. The study also showed a statistically significant increase of post-fasting high density lipoprotein (HDL-C) and βHB. No significant change was found in post-fasting levels of HbA1c, FPG, triglycerides (TG) or high sensitive CRP. Post-fasting leptin was positively correlated with post-fasting BW, BMI, WC, and HC. Post-fasting βHB was positively correlated with post-fasting TG, HbA1c, and LDL-C. Leptin levels change (pre vs post fasting) was positively correlated with the change in LDL-C levels.
CONCLUSIONS: IF reduced leptin and increased β-hydroxybutyrate levels. IF is an effective tool for losing weight and visceral fat and improving lipid profile in obese and overweight patients with T2D.