Browsing by Subject "tyypin 2 diabetes"

The association of serum branched chain amino acids with insulin resistance, risk of type 2 diabetes and intake of macronutrients Both type 2 diabetes and insulin resistance have been associated with elevated concentrations of blood branched-chain amino acids (BCAA). However, it is not yet known why blood BCAA levels are elevated in people in an insulin-resistant state or how lifestyle and nutrition may affect blood BCAA concentrations. The aim of this study was to determine whether a high serum BCAA concentration is associated with the risk of developing type 2 diabetes and insulin resistance in men and women with impaired glucose tolerance (IGT). The association between macronutrient intake and serum BCAA concentration was also explored in this study. Serum BCAA concentration was analysed at baseline and after 1 year in 128 men and 279 women participating in the Finnish Diabetes Prevention Study (DPS). At baseline, all participants were middle-aged, had been diagnosed with IGT and were classified as overweight. All participants were monitored for T2D onset by oral glucose tolerance testing annually, over an average period of 9 years. Anthropometric measurements, blood samples and 3-day food diaries were collected at baseline and at year 1. Gender-specific quartiles of baseline BCAA were used to categorize the participants (Q1, Q2, Q3, Q4); Cox regression was used to analyse diabetes risk among the BCAA categories. Linear regression analysis was used to test for an association between BCAA concentration and a homeostatic model of insulin resistance (HOMA-IR) and macronutrient intake. In addition, linear regression analysis was used to test for an association between changes in BCAA concentration from baseline to year 1 and changes of HOMA-IR and macronutrient intake. The models were adjusted for age, education, gender and body mass index. In addition, the intakes of macronutrients were adjusted for energy intake. Serum BCAA concentration at baseline was associated with the development of T2D (Q4 vs. Q1 HR=1.72 [1.07–2.75]; Q3 vs. Q1 HR=1.69 [1.05–2.70]; Q2 vs. Q1 HR=1.06 [0.63–1.77]). BCAA concentration correlated with HOMA-IR (β=0.20; p<0.001) but changes in BCAA concentration was not associated with changes in HOMA-IR. In men, there was an inverse correlation between baseline BCAA and baseline energy intake (β=−0.23; p=0.01), while protein intake relative to energy intake was directly correlated with BCAA concentration (β=0.19; p=0.03), although the correlation was attenuated after adjusting (p=0.05). In women, baseline fat intake was correlated with BCAA (β=0.26; p=0.04), although the correlation was attenuated after adjusting (p=0.08). In women, a change in the intake of saturated fat correlated with a change in BCAA (β=0.17; p=0.04). The results of this study support earlier findings that, in people with IGT, elevated blood BCAA concentration is associated with insulin resistance and the risk of developing type 2 diabetes. This study also showed that the intake of macronutrients is differentially associated with blood BCAA concentration in men and women. Additionally, this study suggests that macronutrient intake may be associated with blood BCAA concentration. Futher studies are required to determine whether macronutrient intake modifies the association between blood BCAA concentration and risk of developing type 2 diabetes.