Diets High in Carbohydrate May Not Be Appropriate for Rs328 G Carriers with the Metabolic Syndrome

高碳水化合物的饮食可能不适合携带rs328 G等位基因的代谢综合征患者

Shi-Xiu Zhang ； Yi-Yi Ma ； Hong-Wei Guo ； Wen-Tao Wan ； Kun Xue

《Asia Pacific Journal of Clinical Nutrition》 24卷3期 (2015/09) Pp. 546-554

https://doi.org/10.6133/apjcn.2015.24.3.17

摘要

本研究旨在探讨代谢综合征人群脂蛋白脂酶基因多态性在调节高碳水化合物饮食与胰岛素抵抗相关参数中的作用。通过多阶段抽样的方法，在上海市的两个城区筛选出代谢综合征患者，并将筛选出的研究对象按照区域划分为对照组和干预组（n=235）。营养干预期为一年，旨在教育研究对象增加全谷类食物、蔬菜、水果的摄入，减少钠、单糖和膳食脂肪（尤其是烹调油和猪油）的摄入。干预组rs328 CC基因型患者空腹血糖降低（p=0.028），而rs328 G等位基因携带者血糖没有显著变化（p=0.686）。同时，本文还对合并了干预组和对照组的基线资料进行了一个横断面研究分析，分析碳水化合物或脂肪与脂蛋白脂酶基因多态对稳态模型评估的胰岛素抵抗指数／胰岛素／空腹血糖的交互作用。碳水化合物摄入量与稳态模型评估的胰岛素抵抗指数在rs328 G等位基因携带者中呈正相关，而在CC基因型患者中没有关联（交互作用p=0.025）。上述分析结果表明，高碳水化合物饮食可能不适合携带rs328 G等位基因的代谢综合征患者，不同基因型的代谢综合征患者可能需要不同的饮食方案。

關鍵字

基因膳食交互作用 ； 碳水化合物 ； 脂蛋白脂酶 ； 代谢综合征 ； 胰岛素抵抗

並列摘要

The objective of this study was to test how the genetic polymorphisms located within the lipoprotein lipase (LPL) locus would modulate the relationship between a diet high in carbohydrate and insulin resistance related traits in metabolic syndrome adults. A one year nutritional intervention study focusing on education to increase dietary intake of whole grain, vegetable and fruit, and to reduce the intake of sodium, simple sugar and dietary fat (especially cooking oil and pork lard) was conducted. Two districts in Shanghai, China were randomly selected to be the intervention and control group, and patients (n=235) with metabolic syndrome within these two districts were selected based on a multistage sampling method. Fasting glucose was reduced in rs328 CC homozygotes (p=0.028) but not G carriers (p=0.686) within the intervention group. Also an ancillary study with greater statistical power by combining the baseline measurements across both the intervention and control groups was conducted to test the cross-sectional statistical interactions between carbohydrate/fat and lipoprotein lipase genotypes for homeostasis model assessment of insulin resistance/insulin/fasting glucose. Increased carbohydrate intakes were positively associated with homeostasis model assessment of insulin resistance and insulin in rs328 G carriers but not CC homozygotes (p for interaction was 0.025). These results indicate that diet high in carbohydrate may not be suitable for metabolic syndrome rs328 G carriers, calling for the development of personalized dietary intervention for metabolic syndrome subjects.

並列關鍵字

gene-by-diet interaction ； carbohydrate ； lipoprotein lipase ； metabolic syndrome ； insulin resistance