骨脆性是公认的2型糖尿病(T2DM)的并发症,增加患者发病率。因此,迫切需要开发有效的干预措施来预防糖尿病性骨脆性。由于生活方式干预是糖尿病管理的有效选择,它可能对骨骼健康有影响。虽然研究表明膳食纤维在T2DM管理中的有益作用,其对骨骼健康的影响尚不清楚。因此,我们调查了高纤维饮食对2型糖尿病男性和女性骨骼和血糖控制的影响.45例T2DM患者(HbA1c:6.5%±0.49%,年龄:74±7.29岁),计划进行髋关节置换术,随机分配高纤维饮食(38g/天)或不改变饮食12周。有趣的是,高纤维饮食组的BMI下降了4%(p<0.0001),HbA1c下降了3.4%(p<0.0001),但对照组没有下降。然而,在高纤维饮食组中,骨形成标志物1型前胶原氨基末端前肽(P1NP)的血清浓度降低了8.6%(p=.0004),而对照组保持不变。相比之下,与对照组相似,血清中I型胶原骨吸收标记物C末端端肽(CTX)的浓度在高纤维饮食组中没有变化。骨显微CT分析显示,高纤维饮食组和对照组之间的小梁和皮质骨参数没有变化。同样,实时(RT)-PCR分析骨组织显示Wnt通路相关基因的基因表达没有变化(Sost,Dkk-1,Wnt10b,和Lef-1),骨形成标记(Runx2、Col1a1和Ocn),和炎症细胞因子(IL-6,IL-8,TNF-α,和IL-10)在两组之间。我们的研究结果表明,12周的高纤维饮食干预可改善T2DM患者的代谢结局。然而,它可以减少骨形成而不影响骨微结构或Wnt通路调节。
Bone fragility is a recognized complication of type 2 diabetes mellitus (T2DM), increasing patient morbidity. Thus, the development of an effective intervention to prevent diabetic bone fragility is urgently needed. As lifestyle intervention represents an effective option for diabetes management, it may have an impact on bone health. While studies have shown a beneficial effect of dietary fiber in T2DM management, its effect on bone health is still unclear. Thus, we investigated the impact of a high-fiber diet on bone and glucose control in men and women with T2DM. Forty-five T2DM patients (HbA1c: 6.5% ± 0.49%, age: 74 ± 7.29 yr) scheduled for hip arthroplasty were randomly assigned to follow a high-fiber diet (38 g/day) or to make no diet changes for 12 wk. Interestingly, BMI decreased by 4% (p <.0001) and HbA1c by 3.4% (p <.0001) in the high-fiber diet group, but did not decrease in the control group. However, serum concentration of the bone formation marker procollagen type 1 amino-terminal propeptide (P1NP) decreased by 8.6 % in the high-fiber diet group (p =.0004), whereas it remained unchanged in the control group. In contrast, similar to the control group, serum concentration of the bone resorption marker C-terminal telopeptide of type I collagen (CTX) concentrations did not change in the high-fiber diet group. Bone microCT analysis revealed no changes in trabecular and cortical bone parameters between the high-fiber diet and control groups. Similarly, real-time (RT)-PCR analysis in bone tissue showed no changes in the gene expression of Wnt pathway-related genes (Sost, Dkk-1, Wnt10b, and Lef-1), bone formation markers (Runx2, Col1a1, and Ocn), and inflammatory cytokines (IL-6, IL-8, TNF-α, and IL-10) between the two groups. Our findings suggest that 12-wk high-fiber diet intervention improves metabolic outcomes in patients with T2DM. However, it may reduce bone formation without affecting bone microarchitecture or Wnt pathway regulation.