山西粗杂粮制品血糖生成指数和胰岛素指数的评估
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摘要
目的：
本试验测定了15种山西粗杂粮制品的血糖生成指数（GⅠ）和胰岛素指数（Ⅱ），填补食物血糖生成指数库中山西特色粗杂粮制品的空白。分析粗杂粮制品对血糖相关代谢的影响，为饮食防治糖尿病、心血管疾病、肥胖等慢性代谢性疾病奠定基础。
方法：
采用国际认可的食物GⅠ、Ⅱ测定方法，测定8种单品杂粮，7种混合杂粮的GⅠ、Ⅱ值。各受试物均含碳水化合物50g，采用50g纯葡萄糖粉为对照物。每10人为一组测定其空腹血糖、血胰岛素后食用受试物，于服后15、30、45、60、90、120分钟测定餐后血糖、血胰岛素水平。每组受试者测定4种受试物，共进行4组。
GⅠ的计算：以葡萄糖粉为参照物（GⅠ=100），计算各受试物血糖应答曲线下面积(AUC)，AUC除以100即为GⅠ值。采用Wolever的方法，由相应软件完成。
Ⅱ的计算：以葡萄糖粉为参照物（Ⅱ=100），计算各受试物胰岛素应答曲线下面积(AUC)，AUC除以100即为Ⅱ值。采用Wolever的方法，由相应软件完成。
血糖应答曲线：以时间为横坐标，各时点血糖值为纵坐标，制作血糖应答曲线。
胰岛素应答曲线：以各时点胰岛素值作图，制作胰岛素应答曲线。
胰岛素与血糖应答曲线下面积比（Ⅰns/glu）：根据受试物各时点胰岛素和血糖应答曲线下面积，计算每种受试物各时点的胰岛素与血糖的面积比。
结果：
1. GⅠ值：单品杂粮中，高粱面鱼鱼、豆面河捞、炒小米为低GⅠ（GⅠ＜55）食物；玉米面窝窝为高GⅠ（GⅠ＞70）食物；其他单品为中GⅠ（55＜GⅠ＜70）食物；混合杂粮中，三合面面条和黄蒸为中GⅠ食物，其他混合杂粮均为低GⅠ食物。
2.Ⅱ值：15种粗杂粮制品的Ⅱ值都较葡萄糖低，单品杂粮中以豆面河捞最低，混合杂粮中拨鱼Ⅱ值最低。
3.血糖应答：葡萄糖粉在进食30min达到血糖高峰；多数粗杂粮制品的血糖峰值出现在45min，曲线平稳，峰值较低，餐后血糖波动小。
4.胰岛素应答：葡萄糖粉及受试物均在进食30min时达到血胰岛素高峰。粗杂粮制品餐后血胰岛素曲线平稳、波动较小，峰值较低，分泌速度与总量较葡萄糖粉低。
5.受试物不同时点的胰岛素与血糖应答曲线下面积比（Ⅰns/glu）：受试物Ⅰns/glu值均小于葡萄糖粉，混合杂粮的餐后胰岛素敏感性更高。
结论：
本次试验评估了山西粗杂粮制品的GI、II值，补充和丰富了现有的食物GI数据库。粗杂粮制品可以延缓餐后血糖升高速度，降低血糖峰值，稳定餐后血糖状态，增加胰岛素敏感性，减轻胰岛素抵抗（IR）状态。混合杂粮的GI、II值较单品杂粮更低，对稳定血糖的意义更大，可用于糖尿病、心血管疾病等IR相关慢性代谢性疾病的饮食干预及相应的食品开发。
Objective:
Study determined the glycemic index (GI) and Insulin index (II) of 15 kinds of Shanxicoarse grains foods, and filled the GI database of Shanxi coarse grains foods. The advantages ofcoarse grains on blood glucose related metabolism were investigated for further study ondietary intervention diabetes, cardiovascular disease, obesity and other chronic metabolicdiseases.
Method:
Used the standard determination of food GI, II accepted internationally , determined 8kinds of single foods, 7 kinds of mixed foods. Each contains 50g carbohydrates. And used 50gof pure glucose powder as control food. 10 people in each group,and all of them were tested offasting blood glucose and blood insulin, then were given the test food. Determinedpostprandial blood glucose, blood insulin levels at 15, 30, 45, 60, 90, 120min after eating. 4kinds of foods in each group were determinate ,4 groups in totle.
GI calculation: Glucose as a reference (GI = 100), calculated the test foods blood glucoseresponse area under the curve (AUC), AUC divided by 100 to obtain the GI value. GI computedby Wolever method use Specific software.
Calculation II: Glucose as a reference (GI = 100), calculated the test foods insulin response areaunder the curve (AUC), AUC divided by 100 to get the II value. II computed by Wolevermethod use Specific software.
Blood glucose response curve: Took time as abscissa and the value of blood glucose at eachtime point as ordinate, drew glucose response curve.
Insulin response curve: According to the value of insulin at each time point, made the insulinresponse curve.
The ratio of Insulin and blood glucose response area under curve（Ins/glu）: According to bloodglucose AUC and insulin AUC, calculated the AUC ratio.
Results:
1. GI values:In single products, Sorghum flour yuyu, bean flour helao, fried millet were low GIfoods(GI＜55),Cornmeal wowo was high GI food(GI＞70),the other single products were middle GI foods(55＜GI＜70).In mixed product, the noodles mixed by three kinds of flour andhuangzheng were the middle GI food, other products were low GI foods.
2.Ⅱvalue: TheⅡof test foods were lower than glucose . Bean flour helao was the lowest singleproduct. The boyu was the lowest mixed product.
3. Glycemic response: glucose peaked at 30min, most coarse grains products peaked at 45min.The blood sugar curve of the test foods were smooth and peaked lower, postprandial bloodglucose had fewer changes.
4. Insulin response: glucose and coarse grains products all peaked at 30min. The blood insulincurve of the test foods were smooth and peaked lower, the speed and volume of the secretionwere lower than glucose load.
5. Different time points of the ratio of Insulin and blood glucose response area under curve ofthe test foods (Ins/glu): the Ins/glu of test foods were lower than glucose load, the mixtureswere higher in postprandial insulin sensitivity.
ConclusionsConclusions:
Study determined the glycemic index (GI) and Insulin index (Ⅱ) of Shanxi coarse grainsfoods, and filled the GI database of Shanxi coarse grains foods. The coarse grains foods candelay the speed of hyperglycemia postprandial reach to peak, and reduce the blood sugar ,steady postprandial hyperglycemia, increase insulin sensitivity, reduce insulin resistance (IR).The GI,Ⅱvalue of the mixed foods were lower than those of single foods, and moremeaningful to stabilize blood sugar, can also be used on diabetes, cardiovascular disease andother IR-related metabolic diseases of chronic dietary intervention and the corresponding fooddevelopment.
本试验测定了15种山西粗杂粮制品的血糖生成指数（GⅠ）和胰岛素指数（Ⅱ），填补食物血糖生成指数库中山西特色粗杂粮制品的空白。分析粗杂粮制品对血糖相关代谢的影响，为饮食防治糖尿病、心血管疾病、肥胖等慢性代谢性疾病奠定基础。
方法：
采用国际认可的食物GⅠ、Ⅱ测定方法，测定8种单品杂粮，7种混合杂粮的GⅠ、Ⅱ值。各受试物均含碳水化合物50g，采用50g纯葡萄糖粉为对照物。每10人为一组测定其空腹血糖、血胰岛素后食用受试物，于服后15、30、45、60、90、120分钟测定餐后血糖、血胰岛素水平。每组受试者测定4种受试物，共进行4组。
GⅠ的计算：以葡萄糖粉为参照物（GⅠ=100），计算各受试物血糖应答曲线下面积(AUC)，AUC除以100即为GⅠ值。采用Wolever的方法，由相应软件完成。
Ⅱ的计算：以葡萄糖粉为参照物（Ⅱ=100），计算各受试物胰岛素应答曲线下面积(AUC)，AUC除以100即为Ⅱ值。采用Wolever的方法，由相应软件完成。
血糖应答曲线：以时间为横坐标，各时点血糖值为纵坐标，制作血糖应答曲线。
胰岛素应答曲线：以各时点胰岛素值作图，制作胰岛素应答曲线。
胰岛素与血糖应答曲线下面积比（Ⅰns/glu）：根据受试物各时点胰岛素和血糖应答曲线下面积，计算每种受试物各时点的胰岛素与血糖的面积比。
结果：
1. GⅠ值：单品杂粮中，高粱面鱼鱼、豆面河捞、炒小米为低GⅠ（GⅠ＜55）食物；玉米面窝窝为高GⅠ（GⅠ＞70）食物；其他单品为中GⅠ（55＜GⅠ＜70）食物；混合杂粮中，三合面面条和黄蒸为中GⅠ食物，其他混合杂粮均为低GⅠ食物。
2.Ⅱ值：15种粗杂粮制品的Ⅱ值都较葡萄糖低，单品杂粮中以豆面河捞最低，混合杂粮中拨鱼Ⅱ值最低。
3.血糖应答：葡萄糖粉在进食30min达到血糖高峰；多数粗杂粮制品的血糖峰值出现在45min，曲线平稳，峰值较低，餐后血糖波动小。
4.胰岛素应答：葡萄糖粉及受试物均在进食30min时达到血胰岛素高峰。粗杂粮制品餐后血胰岛素曲线平稳、波动较小，峰值较低，分泌速度与总量较葡萄糖粉低。
5.受试物不同时点的胰岛素与血糖应答曲线下面积比（Ⅰns/glu）：受试物Ⅰns/glu值均小于葡萄糖粉，混合杂粮的餐后胰岛素敏感性更高。
结论：
本次试验评估了山西粗杂粮制品的GI、II值，补充和丰富了现有的食物GI数据库。粗杂粮制品可以延缓餐后血糖升高速度，降低血糖峰值，稳定餐后血糖状态，增加胰岛素敏感性，减轻胰岛素抵抗（IR）状态。混合杂粮的GI、II值较单品杂粮更低，对稳定血糖的意义更大，可用于糖尿病、心血管疾病等IR相关慢性代谢性疾病的饮食干预及相应的食品开发。
Objective:
Study determined the glycemic index (GI) and Insulin index (II) of 15 kinds of Shanxicoarse grains foods, and filled the GI database of Shanxi coarse grains foods. The advantages ofcoarse grains on blood glucose related metabolism were investigated for further study ondietary intervention diabetes, cardiovascular disease, obesity and other chronic metabolicdiseases.
Method:
Used the standard determination of food GI, II accepted internationally , determined 8kinds of single foods, 7 kinds of mixed foods. Each contains 50g carbohydrates. And used 50gof pure glucose powder as control food. 10 people in each group,and all of them were tested offasting blood glucose and blood insulin, then were given the test food. Determinedpostprandial blood glucose, blood insulin levels at 15, 30, 45, 60, 90, 120min after eating. 4kinds of foods in each group were determinate ,4 groups in totle.
GI calculation: Glucose as a reference (GI = 100), calculated the test foods blood glucoseresponse area under the curve (AUC), AUC divided by 100 to obtain the GI value. GI computedby Wolever method use Specific software.
Calculation II: Glucose as a reference (GI = 100), calculated the test foods insulin response areaunder the curve (AUC), AUC divided by 100 to get the II value. II computed by Wolevermethod use Specific software.
Blood glucose response curve: Took time as abscissa and the value of blood glucose at eachtime point as ordinate, drew glucose response curve.
Insulin response curve: According to the value of insulin at each time point, made the insulinresponse curve.
The ratio of Insulin and blood glucose response area under curve（Ins/glu）: According to bloodglucose AUC and insulin AUC, calculated the AUC ratio.
Results:
1. GI values:In single products, Sorghum flour yuyu, bean flour helao, fried millet were low GIfoods(GI＜55),Cornmeal wowo was high GI food(GI＞70),the other single products were middle GI foods(55＜GI＜70).In mixed product, the noodles mixed by three kinds of flour andhuangzheng were the middle GI food, other products were low GI foods.
2.Ⅱvalue: TheⅡof test foods were lower than glucose . Bean flour helao was the lowest singleproduct. The boyu was the lowest mixed product.
3. Glycemic response: glucose peaked at 30min, most coarse grains products peaked at 45min.The blood sugar curve of the test foods were smooth and peaked lower, postprandial bloodglucose had fewer changes.
4. Insulin response: glucose and coarse grains products all peaked at 30min. The blood insulincurve of the test foods were smooth and peaked lower, the speed and volume of the secretionwere lower than glucose load.
5. Different time points of the ratio of Insulin and blood glucose response area under curve ofthe test foods (Ins/glu): the Ins/glu of test foods were lower than glucose load, the mixtureswere higher in postprandial insulin sensitivity.
ConclusionsConclusions:
Study determined the glycemic index (GI) and Insulin index (Ⅱ) of Shanxi coarse grainsfoods, and filled the GI database of Shanxi coarse grains foods. The coarse grains foods candelay the speed of hyperglycemia postprandial reach to peak, and reduce the blood sugar ,steady postprandial hyperglycemia, increase insulin sensitivity, reduce insulin resistance (IR).The GI,Ⅱvalue of the mixed foods were lower than those of single foods, and moremeaningful to stabilize blood sugar, can also be used on diabetes, cardiovascular disease andother IR-related metabolic diseases of chronic dietary intervention and the corresponding fooddevelopment.
引文
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〔1〕Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes,and cardiovascular disease[J]. JAMA,2002,287(18):2414-2423.
〔2〕Liu S, Willett WC. Dietary Glycemic Load and Atherothrombotic Risk[J]. CurrentAtherosclerosis Reports,2002,4(6):454–461.
〔3〕王红伟,杨月欣.餐后血糖应答反应的影响因素及其调控[J].卫生研究,2006,35(2):234-237.
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〔7〕Homko CJ, Cheung P, Boden G.Effects of free fatty acids on glucose uptake andutilization in healthy women[J].Diabetes,2003,52(2):487-491.
〔8〕余闻静.Ⅱ型糖尿病发病机制的研究进展[J].科学之友.2008,10(29):158-159.
〔9〕Yki-J?rvinen H. Toxicity of Hyperglycaemia in Type 2 Diabetes [J].Diabetes MetabRev,1998,9(14):S45-S50.
〔10〕Moran A; Zhang HJ; Olson LK, et al. Differentiation of glucose toxicity from beta cellexhaustion during the evolution of defective insulin gene expression in the pancreaticislet cell line,HIT-T15[J].J Clin Invest,1997,99(3):534-539.
〔11〕鲍陶陶.2型糖尿病胰岛β细胞功能受损的中西医病机探讨[J].安徽中医学院学报,2006,25(3):36-37.
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〔1〕Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes,and cardiovascular disease[J]. JAMA,2002,287(18):2414-2423.
〔2〕Liu S, Willett WC. Dietary Glycemic Load and Atherothrombotic Risk[J]. CurrentAtherosclerosis Reports,2002,4(6):454–461.
〔3〕王红伟,杨月欣.餐后血糖应答反应的影响因素及其调控[J].卫生研究,2006,35(2):234-237.
〔4〕刘彩虹,李晓明,赵秋玲.食物血糖生成指数与相关慢性病的关系研究进展[J].中国慢性病预防与控制.2007,15(4):408-450.
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〔6〕David S. Ludwig. Dietary Glycemic Index and Obesity[J].J Nutr,2000,130(2sSuppl):280s-283s.
〔7〕Homko CJ, Cheung P, Boden G.Effects of free fatty acids on glucose uptake andutilization in healthy women[J].Diabetes,2003,52(2):487-491.
〔8〕余闻静.Ⅱ型糖尿病发病机制的研究进展[J].科学之友.2008,10(29):158-159.
〔9〕Yki-J?rvinen H. Toxicity of Hyperglycaemia in Type 2 Diabetes [J].Diabetes MetabRev,1998,9(14):S45-S50.
〔10〕Moran A; Zhang HJ; Olson LK, et al. Differentiation of glucose toxicity from beta cellexhaustion during the evolution of defective insulin gene expression in the pancreaticislet cell line,HIT-T15[J].J Clin Invest,1997,99(3):534-539.
〔11〕鲍陶陶.2型糖尿病胰岛β细胞功能受损的中西医病机探讨[J].安徽中医学院学报,2006,25(3):36-37.
〔12〕Drucker DJ.The role of gut hormones in glucose homeostasis[J].J Clin Invest,2007,117(1):24-32.
〔13〕Campfield LA,Smith FJ.Transient declines in blood glucose signal meal initiation[J].Int JObes.1990,14(suppl3):15-31.
〔14〕Campfield LA,Smith FJ.Rosenbaum M, et al.Human eating:evidence for a physiologicalbasis using a modified paradigm[J].Neurosci biobehav Rev,1996,20(1):133-137.
〔15〕Sichieri R,Moura AS,Genelhu V,et al. An 18-mo randomized trial of alow-glycemic-index diet and weight change in Brazilian women[J].Am J Clin Nutr,2007,86(3):707-713.
〔16〕Barclay AW,Petocz P,McMillan-Price J,et al.Glycemic index,glycemic load,and chronicdisease risk-a meta analysis of observational studies[J].Am J ClinNutr,2008,87(3):627-637.
〔17〕Pacher P,liaudet L, Soriano FG,et a1.The role of poly(ADP-ribose)polymerase activationin the development of myocardial and endothelial dysfuction indiabetes[J].Diabetes,2002,51(2):514-521.
〔18〕孙建琴,张鑫毅,宗敏,等.低血糖指数膳食改善超重老年糖尿病患者氧化应激水平[J].中国组织工程研究与临床康复,2007,11(47):9500-9502.
〔19〕Dickinson S,Hancock DP,Petocz P,et al.High glycemic index carbohydrate increasesnuclear factor- kappaB activation in mononuclear cells of young, lean healthysubjects[J].Am J Clin Nutr,2008,87(5):1188-1193.
〔20〕Jensen L,Sloth B,Krog-Mikkelsen I,et al.A low-glycemic-index diet reduces plasmaplasminogen activator inhibitor-1 activity,but not tissue inhibitor of proteinases-1 orplasminogen activator inhibitor-1 protein,in overweight women[J].Am J ClinNutr,2008,87(1):97-105.
〔21〕赵文华,张坚,黄李春,等.膳食碳水化合物和生糖负荷与成人血脂异常危险关系的研究[J].营养学报,2008,3O(4):350-353.
〔22〕Liu S, Willett WC, Stampfer MJ, et al.A prospective study of dietary glycemic load,carbohydrate intake, and risk of coronary heart disease in US women[J].Am J Clin Nutr2000,71(6):1455-1461.
〔23〕Truswell AS. Glycemic index of foods[J]. Eur J Clin Nutr,1992,46(Suppl2):s91-s101.
〔24〕Monro JA,Shaw M.Glycemic impact,glycemic glucose equivalents,glycemic index,andglycemic load:definitions,distinctions,and implications[J]. Am J Clin Nutr.2008,87(1):237S-243S.