Effects of normal caloric high-protein diet on metabolic parameters and gastrointestinal hormones in patients with obesity or type 2 diabetes mellitus / 中华临床营养杂志

ABSTRACT

Objective To investigate the effects of normal caloric high-protein diet on metabolic parameters and gastrointestinal hormones in patients with obesity or type 2 diabetes mellitus (T2DM).Methods Totally 30 obese subjects (OB group) and 40 obese patients with type 2 diabetes mellitus (T2DM group) received normal caloric high-protein diet for 24 weeks.Then body weight,fat mass,and metabolic parameters were assessed.The serum ghrelin and glucagon-like peptide-1 (GLP-1) levels were also measured at 0 and 2 h after an oral 100 g of steamed bread meal test.Results After 24 weeks,body weight [(78.23 ± 7.51) kg vs (80.83±8.13) kg,P=0.016; (80.45±7.48) kg vs (83.26±9.35) kg,P=0.011],body mass index [(31.03 ±2.72) kg/m2 vs (32.01 ±2.95) kg/m2,P=0.033; (32.63 ±2.81) kg/m2 vs (33.86±3.03) kg/m2,P =0.043],waist circumference [(93.65 ± 6.23) cm vs (97.30 ± 7.81) cm,P =0.041 ;(97.02±7.43) cm vs (101.87 ±9.87) cm,P =0.034],fat mass [(30.42 ±6.18) kg vs (32.47 ±5.91) kg,P=0.022; (34.23 ±7.03) kg vs (36.64 ±6.83) kg,P =0.032],fasting serum insulin [(10.81±3.69) mmol/Lvs (13.58±4.86) mmol/L,P=0.012; (9.58±3.51) mmol/Lvs (10.82±4.28) mmol/L,P =0.015],HOMA-insulin resistance index [(2.42 ± 0.83) vs (3.16 ± 1.21),P =0.019; (3.15±0.74) vs (4.13±0.67),P=0.024] and triglycerides [(1.24±0.32) mmol/Lvs (1.49±0.52) mmol/L,P=0.046; (1.86±1.05) mmol/L vs (2.46±1.85) mmol/L,P=0.034] were significantly decreased in OB and T2DM groups,respectively,compared with 0 week.Fasting blood glucose (FBG)and glycosylated hemoglobin were also significantly declined in T2DM group [FBG(6.73 ± 1.25) mmol/Lv s (8.63 ±2.81)) mmol/L,P=0.010; HbA1c (6.44 ±0.47) vs (7.38 ±0.33),P=0.031].The serum ghrelin and GLP-1 both increased at 0h and 2 h after meal test in OB and T2DM groups [fasting serum ghrelin(4.98 ±0.89) μg/L vs (3.95 ±0.98) μg/L,P=0.021; (4.23 ± 1.67) μg/L vs (3.15 ± 1.01) μgL,P=0.025; 2 h postprandial serum ghrelin(2.98 ±0.96) μg/L vs (2.56 ±0.83) μg/L,P =0.046; (2.83 ± 1.03) μg/L vs (1.95 ±0.92) μg/L,P =0.033; fasting serum GLP-1(6.06 ±0.63) μg/L vs (5.13±0.59) μg/L,P=0.041; (5.23±0.71) μg/Lv s (4.49±0.53) μg/L,P=0.039; 2 h postprandialserum GLP-1(10.01±1.01) μg/L vs (7.68±0.94) μg/L,P=0.007; (8.87±0.94) μg/Lvs (6.59 ± 0.87) μg/L,P =0.013].Conclusions Normal caloric high-protein diet can reduce body weight and serum glucose.Those effects may be due to the increase in secretion of GLP-1.