OBJECTIVE To compare the effect of an isocaloric multifactorial diet with a diet rich in monounsaturated fatty acids (MUFA) and similar macronutrient composition on pancreatic fat (PF) and postprandial insulin response in type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS According to a randomized controlled parallel-group design, 39 individuals with T2D, 35–75 years old, in satisfactory blood glucose control, were assigned to an 8 week isocaloric intervention with a multifactorial diet rich in MUFA, polyunsaturated fatty acids, fiber, polyphenols, and vitamins (n = 18) or a MUFA-rich diet (n = 21). Before/after the intervention, PF content was measured by the proton-density fat fraction using a three-dimensional mDIXON MRI sequence, and plasma insulin and glucose concentrations were measured over a 4 h test meal with a similar composition as the assigned diet. RESULTS After 8 weeks, PF significantly decreased after the multifactorial diet (from 15.7 ± 6.5% to 14.1 ± 6.3%; P = 0.024), while it did not change after the MUFA diet (from 17.1 ± 10.1% to 18.6 ± 10.6%; P = 0.139) with a significant difference between diets (P = 0.014). Postprandial glucose response was similar in the two groups. Early postprandial insulin response (incremental postprandial areas under the curve [iAUC0–120]) significantly increased with the multifactorial diet (from 36,340 ± 34,954 to 44,138 ± 31,878 pmol/L/min; P = 0.037), while it did not change significantly in the MUFA diet (from 31,754 ± 18,446 to 26,976 ± 12,265 pmol/L/min; P = 0.178), with a significant difference between diets (P = 0.023). Changes in PF inversely correlated with changes in early postprandial insulin response (r = −0.383; P = 0.023). CONCLUSIONS In patients with T2D, an isocaloric multifactorial diet, including several beneficial dietary components, markedly reduced PF. This reduction was associated with an improved postprandial insulin response.

中文翻译：

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等能多因素饮食可减少 2 型糖尿病患者的胰腺脂肪并增加餐后胰岛素反应：一项随机对照试验

目的比较等热量多因素饮食与富含单不饱和脂肪酸 (MUFA) 和类似常量营养素组成的饮食对 2 型糖尿病 (T2D) 患者胰腺脂肪 (PF) 和餐后胰岛素反应的影响。研究设、纤维、多酚和维生素（n = 18）或富含 MUFA 的饮食（n = 21）。在干预之前/之后，使用三维 mDIXON MRI 序列通过质子密度脂肪分数测量 PF 含量，在 4 小时的试验餐中测量血浆胰岛素和葡萄糖浓度，其成分与指定的饮食相似。结果 8 周后，多因素饮食后 PF 显着下降（从 15.7 ± 6.5% 到 14.1 ± 6.3%；P = 0.024），而在 MUFA 饮食后没有变化（从 17.1 ± 10.1% 到 18.6 ± 10.6%； P = 0.139），饮食之间存在显着差异（P = 0.014）。两组的餐后血糖反应相似。早期餐后胰岛素反应（增加的餐后曲线下面积 [iAUC0-120]）随多因素饮食显着增加（从 36,340 ± 34,954 到 44,138 ± 31,878 pmol/L/min；P = 0.037），而在MUFA 饮食（从 31,754 ± 18,446 到 26,976 ± 12,265 pmol/L/min；P = 0.178），饮食之间存在显着差异（P = 0.023）。PF 的变化与早期餐后胰岛素反应的变化呈负相关（r = -0.383；P = 0.023）。结论 在 T2D 患者中，等热量的多因素饮食，包括几种有益的饮食成分，可显着降低 PF。这种减少与改善的餐后胰岛素反应有关。