| 摘要: | 隨糖尿病病程進展，患者體內的醣類代謝、荷爾蒙恆定會發生改變，且臨床上亦發現患者對甜味的感受異常，可能使其不易遵從飲食原則，導致血糖難以控制。故本研究欲觀察第 2 型糖尿病患者和健康者之甜味識別閾值及餐後荷爾蒙反應，並探討血糖相關指標及荷爾蒙與識別閾值之相關性。研究共招募 21 位健康者及 29 位第 2 型糖尿病患者，評估其之蔗糖溶液識別閾值及餐後荷爾蒙反應。結果顯示，第 2 型糖尿病組之蔗糖識別閾值顯著高於健康組，且識別閾值與 HbA1c (Glycated hemoglobin) 呈正相關，但與空腹血糖、胰島素、GLP-1 (Glucagon-like peptide-1) 濃度、升糖素及 leptin 則無顯著相關。荷爾蒙反應方面，第 2 型糖尿病組之餐後荷爾蒙反應曲線與健康組不同，其中第 2 型糖尿病組之空腹 C-peptide 及胰島素濃度顯著較高、0-30 分鐘單位時間改變量顯著較低；空腹升糖素濃度顯著較高，空腹 GLP-1 濃度及 0-30 分鐘單位時間改變量亦較低，但無顯著差異。綜合實驗結果，第 2 型糖尿病患者之甜味感受度較健康者差，且程度與 HbA1c 呈正相關，此外，餐後胰島素、升糖素及 GLP-1 之調控能力有受損之趨勢。
Background: Type 2 diabetes (T2DM) is a progressive disease in which abnormal carbohydrate metabolism and impaired hormones regulation are associated with hyperglycemia. Changes in sweet taste perception might alter food preferences in T2DM, resulting in poor dietary compliance. Thus, the purposes of this study was to investigate the sweet sensory and postprandial hormones responses in T2DM and healthy subjects. We also determined the correlations between markers of glycemia, hormones and recognition thresholds.
Design: 21 healthy and 29 T2DM subjects, aged 30-65, were included in this study. For the first part of the study, recognition thresholds of sucrose solutions were determined by whole-mouth method. For the second part of the study, subjects consumed a 400 kcal standard breakfast after fasting overnight, and their blood samples were taken at baseline, 30, 60, 90, 120 min to measure the concentration of hormones.
Results: In the first part, the recognition thresholds of sucrose solutions were found to be significantly higher in T2DM than in healthy subjects. It showed a significantly positive correlative with HbA1c (Glycosylated hemoglobin). But there were no correlation between recognition thresholds of sucrose solutions and fasting plasma glucose, insulin, total GLP-1, glucagon and leptin. In the second part of the study, it was found that the curves of postprandial hormones responses were different between groups of healthy subjects and T2DM. The fasting C-peptide and insulin levels were significantly higher, tAUC0-30 min-1 (total area under the curve 0-30 min-1) were significantly lower, and fasting glucagon levels were significantly higher in T2DM than those in healthy group. Fasting GLP-1 levels and tAUC0-30 min-1 were lower in T2DM than in healthy group; but the differences were not significant.
Conclusion: The findings in this study suggest that T2DM have a blunted taste of sucrose and they show a significantly positive correlative with HbA1c. Moreover, the regulation of postprandial GLP-1, insulin and glucagon may be impaired in T2DM. |
