Postprandial glucose, insulin and incretin responses to different carbohydrate tolerance tests.
BACKGROUND
Few studies have focused on postprandial incretin responses to different carbohydrate meals. Therefore, we designed a study to compare the different effects of two carbohydrates (75 g oral glucose, a monosaccharide and 100 g standard noodle, a polysaccharide, with 75 g carbohydrates equivalently) on postprandial glucose, insulin and incretin responses in different glucose tolerance groups.


METHODS
This study was an open-label, randomized, two-way crossover clinical trial. 240 participants were assigned to take two carbohydrates in a randomized order separated by a washout period of 5-7 days. The plasma glucose, insulin, c-peptide, glucagon and active glucagon-like peptide-1 (AGLP-1) were measured. The incremental area under curve above baseline from 0 to 120 min of insulin (iAUC(0 -120 min)- INS) and AGLP-1(iAUC(0 -120 min)- AGLP-1) was calculated.


RESULTS
Compared with standard noodles, the plasma glucose and insulin after consumption of oral glucose were higher at 30 min (both P < 0.001) and 60 min (both P < 0.001), while lower at 180 min (both P < 0.001), but no differences were found at 120 min. The glucagon at 180 min was higher after consumption of oral glucose (P = 0.010). The AGLP-1 response to oral glucose was higher at 30 min (P < 0.001), 60 min (P < 0.001) and 120 min (P = 0.022), but lower at 180 min (P = 0.027). In normal glucose tolerance (NGT), oral glucose elicited a higher insulin response to the corresponding AGLP-1 (P < 0.001), which was represented by iAUC(0 -120 min) -INS /iAUC(0 -120 min)- AGLP-1, while in type 2 diabetes mellitus (T2DM), standard noodles did (P = 0.001).


CONCLUSIONS
Monosaccharide potentiated more rapid and higher glycemic and insulin responses. Oral glucose of liquid state would elicit a more potent release of AGLP-1. The incretin effect was amplified after consumption of standard noodles in T2DM.
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Yuying
Y
Deng
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Yifei
Y
Zhang
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Sheng
S
Zheng
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Jie
J
Hong
Nutrition and Health Research Institute, COFCO.
Chunling
C
Wang
Nutrition and Health Research Institute, COFCO.
Ting
T
Liu
R&D Division, China Food Limited, COFCO, Beijing, China.
Zhehao
Z
Sun
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Weiqiong
W
Gu
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Yanyun
Y
Gu
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Juan
J
Shi
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Shuangshuang
S
Yao
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Weiqing
W
Wang
Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Division of Endocrinology of E-Institutes of Shanghai, Rui-jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Guang
G
Ning
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood; D002681:China; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000097:blood*; D005260:Female; D005934:Glucagon / Q000097:blood; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D054795:Incretins / Q000097:blood*; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D011237:Predictive Value of Tests; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers; D001786:Blood Glucose; D002096:C-Peptide; D004040:Dietary Carbohydrates; D054795:Incretins; D007328:Insulin; D052216:Glucagon-Like Peptide 1; D005934:Glucagon
carbohydrates; incretin effect; postprandial responses; 关键词：碳水化合物，肠促胰素效应，餐后效应