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Aims/hypothesis <p>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.</p> Methods <p>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 (<i>n</i>=16) or a multifactorial diet rich in MUFA, polyunsaturated fats, fibre, polyphenols and vitamins (<i>n</i>=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.</p> Results <p>Compared with the MUFA diet, the multifactorial diet led to a decrease (8 week minus baseline) in fasting ApoC-III levels (−0.006&#xa0;±&#xa0;0.040 vs +0.007&#xa0;±&#xa0;0.048 g/l, <i>p</i>=0.070) and postprandial ApoC-III AUC (−1.34&#xa0;±&#xa0;6.01 vs +1.60&#xa0;±&#xa0;5.56 g/l&#xa0;×&#xa0;180 min, <i>p</i>=0.043). Regardless of dietary intervention, changes in fasting ApoC-III positively correlated with changes in liver fat (<i>r</i>=0.357, <i>p</i>=0.032) and pancreatic fat (<i>r</i>=0.385, <i>p</i>=0.020). Both fasting and postprandial ApoC-III changes were inversely correlated with beta cell function (<i>r</i>=−0.384, <i>p</i>=0.026; <i>r</i>=−0.402, <i>p</i>=0.018, respectively).</p> Conclusions/interpretation <p>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.</p> Trial registration <p>ClinicalTrials.gov NCT03380416</p> Graphical Abstract <p></p>

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

  • 期刊论文

  • 发表日期：

    2025年6月5日

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

摘要

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

Graphical Abstract