ApoC-III and ectopic fat accumulation in individuals with type 2 diabetes: an exploratory analysis from the MEDEA randomised controlled study.

IF 10.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetologia Pub Date : 2025-09-01 Epub Date: 2025-06-05 DOI:10.1007/s00125-025-06464-w

Giuseppina Costabile, Dominic Salamone, Giuseppe Della Pepa, Roberta Testa, Marilena Vitale, Valentina Brancato, Marco Salvatore, Andrea Soricelli, Giovanni Annuzzi, Angela A Rivellese, Lutgarda Bozzetto

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Abstract

Aims/hypothesis: We aimed to investigate the effects of an isoenergetic multifactorial diet, previously shown to reduce liver and pancreatic fat content, compared with a monounsaturated fatty acid (MUFA)-rich diet, on plasma apolipoprotein C-III (ApoC-III) levels and their relationship with ectopic fat and beta cell function in people with type 2 diabetes.

Methods: In this randomised controlled, parallel group study, 36 individuals with type 2 diabetes (20 men, 16 women), aged 35-75 years, were assigned to an 8 week intervention with either an isoenergetic MUFA-rich diet (n=16) or a multifactorial diet rich in MUFA, polyunsaturated fats, fibre, polyphenols and vitamins (n=20). Fasting and postprandial (3 h test meal reflecting the assigned diet) plasma glucose, insulin and ApoC-III concentrations were measured before and after the intervention. Beta cell function was assessed as the insulin-to-glucose total AUC ratio. Liver and pancreatic fat content were quantified using magnetic resonance techniques.

Results: Compared with the MUFA diet, the multifactorial diet led to a decrease (8 week minus baseline) in fasting ApoC-III levels (-0.006 ± 0.040 vs +0.007 ± 0.048 g/l, p=0.070) and postprandial ApoC-III AUC (-1.34 ± 6.01 vs +1.60 ± 5.56 g/l × 180 min, p=0.043). Regardless of dietary intervention, changes in fasting ApoC-III positively correlated with changes in liver fat (r=0.357, p=0.032) and pancreatic fat (r=0.385, p=0.020). Both fasting and postprandial ApoC-III changes were inversely correlated with beta cell function (r=-0.384, p=0.026; r=-0.402, p=0.018, respectively).

Conclusions/interpretation: A multifactorial diet significantly reduced plasma ApoC-III levels in individuals with type 2 diabetes. Independent of dietary intervention, lower ApoC-III levels were associated with reduced liver and pancreatic fat accumulation and improved beta cell function.

Trial registration: ClinicalTrials.gov NCT03380416.

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2型糖尿病患者ApoC-III和异位脂肪堆积：来自MEDEA随机对照研究的探索性分析

目的/假设：我们旨在研究等能多因子饮食对2型糖尿病患者血浆载脂蛋白C-III （ApoC-III）水平的影响，以及它们与异位脂肪和β细胞功能的关系。先前的研究显示，与富含单不饱和脂肪酸（MUFA）的饮食相比，等能多因子饮食可降低肝脏和胰腺脂肪含量。方法：在这项随机对照、平行组研究中，36名年龄在35-75岁的2型糖尿病患者（20名男性，16名女性）被分配到8周的干预组，干预组采用富含等能MUFA的饮食（n=16）或富含MUFA、多不饱和脂肪、纤维、多酚和维生素的多因子饮食（n=20）。在干预前后测量空腹和餐后（反映指定饮食的3小时试验餐）血糖、胰岛素和ApoC-III浓度。β细胞功能以胰岛素-葡萄糖总AUC比值评估。采用磁共振技术定量测定肝脏和胰腺脂肪含量。结果：与MUFA饮食相比，多因素饮食导致空腹ApoC-III水平（8周减去基线）降低（-0.006±0.040 vs +0.007±0.048 g/l, p=0.070）和餐后ApoC-III AUC（-1.34±6.01 vs +1.60±5.56 g/l × 180 min, p=0.043）。无论饮食干预如何，空腹ApoC-III的变化与肝脏脂肪（r=0.357, p=0.032）和胰腺脂肪（r=0.385, p=0.020）的变化呈正相关。空腹和餐后ApoC-III的变化与β细胞功能呈负相关(r=-0.384, p=0.026；R =-0.402, p=0.018)。结论/解释：多因素饮食可显著降低2型糖尿病患者血浆ApoC-III水平。独立于饮食干预，较低的ApoC-III水平与减少肝脏和胰腺脂肪积累和改善β细胞功能有关。试验注册：ClinicalTrials.gov NCT03380416。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetologia 医学-内分泌学与代谢

CiteScore

18.10

自引率

2.40%

发文量

193

审稿时长

1 months

期刊介绍： Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.