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目的胰岛素抵抗和2型糖尿病、高血压以及CVD(心血管疾病)都相关,但是,涉及到这些代谢异常疾病的饮食因素,仍存误解。在动物实验,糖类(sugars),特别是蔗糖(sucrose)和果糖(fructose),已被证明可降低胰岛素敏感性,同时还和高甘油三酯血症有着潜在的相关性。但在人类,糖类对胰岛素敏感性的影响,仍存争议。方法首先,就糖类影响胰岛素抵抗进展的代谢途径,本文进行了概述;然后,对涉及到糖类、胰岛素抵抗和糖尿病关系的研究(干预性、前瞻性和横断面),进行了系统回顾,以调查涉及糖类摄入和糖尿病关系的证据水平。结果所有这些研究都未能证明,简单碳水化合物总摄入量和血糖控制有明确相关性,或者说,就蔗糖对糖尿病的影响而言,2型糖尿病风险增加的具体证据缺乏。结论旨在审查果糖对糖尿病进展的长期不良影响的研究结论仍不一致。鉴于越来越多的果糖被添加于食品和含糖饮料,其对脂肪生成和甘油三酯的作用必须纳入考虑。
The purpose of insulin resistance and type 2 diabetes, hypertension and CVD (cardiovascular disease) are related, but dietary factors related to these metabolic disorders are still misunderstood. In animal experiments, sugars, particularly sucrose and fructose, have been shown to reduce insulin sensitivity and have a potential correlation with hypertriglyceridemia. But in humans, the impact of sugars on insulin sensitivity remains controversial. Methods First, an overview of the metabolic pathways by which carbohydrates affect insulin resistance progression is provided; then, systematic reviews of the studies (interventional, prospective, and cross-sectional) on the relationships between carbohydrate, insulin resistance and diabetes were performed, To investigate the level of evidence that relates to the relationship between carbohydrate intake and diabetes. Results All these studies failed to show that there was a clear correlation between simple total carbohydrate intake and glycemic control or that there was a lack of concrete evidence of an increased risk of type 2 diabetes in terms of the effect of sucrose on diabetes. Conclusions The findings of studies aimed at examining the long-term adverse effects of fructose on the progression of diabetes are still not consistent. As more and more fructose is added to foods and sugary drinks, its effects on lipogenesis and triglycerides must be taken into account.