黑豆漿取代膳食中部分動物性蛋白質以減少膳食糖化終產物攝取對於糖尿病前期肥胖受試者氧化壓力、發炎反應指標物及腸道菌相之影響

Abstract

根據臺灣衛生福利部資料發現肥胖成年人比例有逐年上升的趨勢，且過重和肥胖為罹患糖尿病前期或第二型糖尿病的危險因子。肥胖者偏好攝取膳食高度糖化終產物 (dietary advanced glycation end products, dAGEs)含量較高的食物，被認為是肥胖者容易罹患慢性疾病的原因之一。黑豆為良好的植物性蛋白質來源，與等量蛋白質的豬肉相比，dAGEs含量明顯較低，因此本試驗以黑豆漿取代膳食中部分葷食蛋白質，探討是否可透過減少dAGEs攝取改善糖尿病前期肥胖者體位、代謝指標及腸道菌叢。本試驗是一個為期16週的隨機交叉介入性試驗，招募20−64歲男性和女性糖尿病前期肥胖受試者，試驗期分成四個階段：0−4週為run-in period，4−8週和12−16週為黑豆漿或熟食豬肉介入期，8−12週為wash-out period，試驗介入期間受試者每日飲用二瓶無加糖黑豆漿或攝取蛋白質含量相當之豬肉做為膳食蛋白質來源。試驗中每兩週會蒐集受試者三日24小時飲食紀錄，並於試驗開始前及介入期前後進行體位測量、採集血液和糞便檢體進行分析。試驗結果顯示，黑豆漿組以每日總熱量校正後的dAGEs攝取量顯著低於豬肉組，且試驗前後血清高度糖化終產物AGEs螢光變化量相較於豬肉組也有下降的趨勢；體組成結果顯示黑豆漿組介入後相較於介入前體脂肪百分比有下降的趨勢。此外，生化指標分析結果顯示黑豆漿組介入後相較於介入前血清丙二醛 (malondialdehyde, MDA)濃度顯著降低，且黑豆漿組相較於豬肉組MDA變化量也有顯著差異。糞便腸道菌相結果顯示，黑豆漿組介入後相較於豬肉組Butyriclcoccus和Lachnospiraceae_UCG-010相對豐富度顯著增加。進一步透過相關性分析發現試驗前後每日dAGEs/energy變化量和MDA變化量呈現正相關。因此，每日膳食若以黑豆漿取代部份動物性蛋白質可以減少dAGEs攝取，並改善糖尿病前期肥胖者體內氧化壓力和腸道菌相。Obesity is a population-wide problem and represents a leading risk factor for diseases; in addition, overweight and obesity are risk factors for prediabetes or type 2 diabetes. Obese adults are accustomed to taking in higher dietary advanced glycation end products (dAGEs), which may lead to chronic diseases. Black soybean is a good source of plant-based protein, and the content of dAGEs is significantly lower than pork with the same amount of protein. Therefore, we investigated the effects of daily consumed black soymilk replacing part of the meat protein in the diet on body composition, metabolic indicators, and gut microbiota in prediabetic obese subjects. This study is a 16- week randomized crossover interventional trial. We recruited 20–64 years old males and females with prediabetic obese subjects. This trial included four periods: 0–4 weeks was the run-in period; 4–8 weeks and 12–16 weeks for black soymilk or meat intervention period; 8–12 weeks was the wash-out period. During the intervention period the subjects consumed black soymilk or meat with a similar protein content as a source of daily dietary protein. The subjects wrote 3-day 24-hour dietary records, and we collected the anthropometric measurement data, blood, and fecal samples for analysis. The results showed that the daily dAGEs intake corrected by energy of the black soymilk group was significantly lower than the meat group, and the changes in serum advanced glycation end products (AGEs) fluorescence had a downward trend compared with the meat group. The biochemical analysis showed a significant decrease in serum MDA levels after the black soymilk intervention, and the change in MDA levels showed a significant difference compared to the meat group. The changes of dAGEs corrected by energy and MDA levels were positive correlation. Additionally, after the intervention of black soymilk, the relative abundance of Butyriclcoccus and Lachnospiraceae_UCG-010 showed a significant increase in the black soymilk group compared to the meat group. Therefore, daily black soymilk consumption to substitute partial animal protein may reduce dAGEs intake and improve the oxidative stress and gut microbiota in prediabetic obese subjects.