BMI status influences the response of insulin sensitivity to diacylglycerol oil in Chinese type 2 diabetic patients.

Present study was a post-hoc analysis and aimed to examine the influence of adiposity status on the response of insulin sensitivity to diacylglycerol (DAG) oil in type 2 diabetic patients. A total of 127 type 2 diabetic patients were recruited into a randomized double-blind controlled parallel trial in Hangzhou, China. Subjects were allocated to consume the same amount (25 mL/d) of DAG (n=66) or triacylglycerol (TAG) oil (n=61) with similar fatty acid compositions for 120 days. Marginally significant interaction was observed between BMI status (overweight versus normal weight) and test oils for fasting insulin (p-interaction=0.046) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (p-interaction=0.059). For normal weight subjects (BMI<=25), DAG group showed significant decrease of fasting insulin (-2.0, 95% CI: -3.90, -0.10; p=0.036) and HOMA-IR (-0.69, 95% CI: -1.36, -0.03; p=0.015), but not in the TAG group. No significant change of either trait in DAG or TAG group was observed for overweight subjects (BMI>25). In summary, the effect of DAG oil on insulin sensitivity in type 2 diabetic patients is influenced by the baseline BMI status. Type 2 diabetic patients may benefit from DAG oil in terms of insulin sensitivity improvement, however only when they are in normal body weight range. 本项二次分析的目的是探讨在中国2型糖尿病患者中进行甘油二酯的干预时，患 者的肥胖状态对其胰岛素敏感性变化的影响。此项随机双盲对照试验共在中国 杭州纳入了127名2型糖尿病患者，所有患者被随机分配到两个组，分别食用相 同体积（ 25 mL/d ） 及相似脂肪酸含量的甘油二酯（ n=66 ） 和甘油三酯 （n=61），持续120天。对空腹胰岛素（p-交互=0.046）和空腹胰岛素抵抗指数 （p-交互=0.059），BMI状态（超重vs 正常体重）和两种油类干预都有边缘性 显著的交互作用。在正常体重患者中（BMI≤25），甘油二酯干预能够使空腹胰 岛素（-2.0, 95% CI: -3.90, -0.10; p=0.036）和胰岛素抵抗指数水平（-0.69, 95% CI: -1.36, -0.03; p=0.015）显著下降，但甘油三酯没有该作用。在超重患者中， 甘油二酯和甘油三酯干预对两种指标都没有显著影响。综上所述，甘油二酯对2 型糖尿病患者胰岛素敏感性的影响受患者基线BMI状态的影响。当2型糖尿病患 者处于正常体重范围内时，食用甘油二酯可能对其胰岛素敏感性的改善有益 处。