背景:身体组成和身体脂肪分布是心脏代谢疾病的重要预测因子。心脏代谢疾病的病因是异质性的,部分由组织特异性胰岛素敏感性的个体间差异驱动。
目的:研究(1)身体成分与全身的关系,肝脏和肌肉胰岛素敏感性,(2)在高不饱和脂肪酸(HMUFA)或低脂等热量饮食12周后,身体成分和胰岛素敏感性的变化及其关系,高蛋白,高纤维(LFHP)饮食。
方法:这项PERSON研究的子队列分析包括93名个体(53%的女性,BMI25-40kg/m2,40-75岁)参加了这项随机干预研究。在基线和12周后LFHP,或HMUFA饮食,我们进行了7点口服葡萄糖耐量试验来评估全身,肝脏,和肌肉胰岛素敏感性,和全身磁共振成像来确定身体成分和体内脂肪分布。这两种饮食都符合健康营养的指导原则。
结果:在基线时,肝脏脂肪含量与更差的肝脏胰岛素敏感性相关(β[95CI];0.12[0.01;0.22])。只有在女人身上,大腿肌肉脂肪含量与肌肉胰岛素敏感性呈负相关(-0.27[-0.48;-0.05])。内脏脂肪组织(VAT)与全身呈负相关,肝脏,和肌肉胰岛素敏感性。两种饮食都降低了增值税,腹部皮下脂肪组织(aSAT),和肝脏脂肪,但不是全身和组织特异性胰岛素敏感性,饮食之间没有差异。腰围,然而,与HMUFA饮食相比,LFHP饮食后下降更多(-3.0vs.-0.5厘米,分别)。在LFHP而不是HMUFA饮食之后,身体成分的改善与全身和肝脏胰岛素敏感性的改善呈正相关.
结论:肝脏和肌肉胰岛素敏感性与肝脏和肌肉脂肪积累明显相关。尽管LFHP和HMUFA饮食在体内脂肪方面都有所改善,VAT,aSAT,和肝脏脂肪,只有LFHP诱导的身体成分改善与胰岛素敏感性改善相关.
背景:NCT03708419(clinicaltrials.gov)。
BACKGROUND: Body composition and body fat distribution are important predictors of cardiometabolic diseases. The etiology of cardiometabolic diseases is heterogenous, and partly driven by inter-individual differences in tissue-specific insulin sensitivity.
OBJECTIVE: To investigate (1) the associations between body composition and whole-body, liver and muscle insulin sensitivity, and (2) changes in body composition and insulin sensitivity and their relationship after a 12-week isocaloric diet high in mono-unsaturated fatty acids (HMUFA) or a low-fat, high-protein, high-fiber (LFHP) diet.
METHODS: This subcohort analysis of the PERSON study includes 93 individuals (53% women, BMI 25-40 kg/m2, 40-75 years) who participated in this randomized intervention study. At baseline and after 12 weeks of following the LFHP, or HMUFA diet, we performed a 7-point oral glucose tolerance test to assess whole-body, liver, and muscle insulin sensitivity, and whole-body magnetic resonance imaging to determine body composition and body fat distribution. Both diets are within the guidelines of healthy nutrition.
RESULTS: At baseline, liver fat content was associated with worse liver insulin sensitivity (β [95%CI]; 0.12 [0.01; 0.22]). Only in women, thigh muscle fat content was inversely related to muscle insulin sensitivity (-0.27 [-0.48; -0.05]). Visceral adipose tissue (VAT) was inversely associated with whole-body, liver, and muscle insulin sensitivity. Both diets decreased VAT, abdominal subcutaneous adipose tissue (aSAT), and liver fat, but not whole-body and tissue-specific insulin sensitivity with no differences between diets. Waist circumference, however, decreased more following the LFHP diet as compared to the HMUFA diet (-3.0 vs. -0.5 cm, respectively). After the LFHP but not HMUFA diet, improvements in body composition were positively associated with improvements in whole-body and liver insulin sensitivity.
CONCLUSIONS: Liver and muscle insulin sensitivity are distinctly associated with liver and muscle fat accumulation. Although both LFHP and HMUFA diets improved in body fat, VAT, aSAT, and liver fat, only LFHP-induced improvements in body composition are associated with improved insulin sensitivity.
BACKGROUND: NCT03708419 (clinicaltrials.gov).