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Diabetologia. 2015 Oct 16. [Epub ahead of print]

The insulin resistance phenotype (muscle or liver) interacts with the type of diet to determine changes in disposition index after 2 years of intervention: the CORDIOPREV-DIAB randomised clinical trial.

Author information

1
Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain.
2
Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain.
3
Department of Medicine, University of Cordoba, Cordoba, Spain.
4
CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN).
5
TNO, Zeist, the Netherlands.
6
Nutrition and Genomics Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
7
IMDEA Food Institute, Madrid, Spain.
8
Lipids and Atherosclerosis Research Unit, Reina Sofia University Hospital, Avda Menendez Pidal, s/n, 14004, Cordoba, Spain. jlopezmir@uco.es.
9
Nutrigenomics and Metabolic Syndrome, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), Cordoba, Spain. jlopezmir@uco.es.
10
Department of Medicine, University of Cordoba, Cordoba, Spain. jlopezmir@uco.es.
11
CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), . jlopezmir@uco.es.

Abstract

AIMS/HYPOTHESIS:

The aim of the study was to determine whether basal insulin resistance (IR) phenotype (muscle and/or liver) determines the effect of long-term consumption of a Mediterranean diet or a low-fat diet on tissue-specific IR and beta cell function.

METHODS:

The study was performed in 642 patients included in The effect of an olive oil rich Mediterranean diet on type 2 diabetes mellitus risk and incidence study (CORDIOPREV-DIAB). A total of 327 patients were randomised to a Mediterranean diet (35% fat; 22% from monounsaturated fatty acids) and 315 to a low-fat diet (<28% fat). At baseline, the patients were classified into four phenotypes according to the type of IR: (1) no IR; (2) muscle IR; (3) liver IR; (4) muscle + liver IR. The hepatic insulin resistance index (HIRI), muscular insulin sensitivity index (MISI) and disposition index were analysed at baseline and after 2 years of follow-up.

RESULTS:

At baseline, 322 patients presented no IR, 106 presented muscle IR, 109 presented liver IR, and 105 presented muscle + liver IR. With both dietary interventions, HIRI decreased in all patients (p < 0.001) and MISI increased in muscle IR and muscle + liver IR patients (p < 0.01). Long-term intake of the Mediterranean diet increased the disposition index and insulinogenic index in the muscle IR patients (p = 0.042 and p = 0.044, respectively) and the disposition index in the muscle + liver IR patients (p = 0.048), whereas the low-fat diet increased the disposition index in the liver IR patients (p = 0.017).

CONCLUSIONS/INTERPRETATION:

Although both diets improve insulin sensitivity, there are differences based on basal IR phenotypes. Moreover, according to insulinogenic and disposition index data, a low-fat diet might be more beneficial to patients with liver IR, whereas patients with muscle IR and muscle + liver IR might benefit more from a Mediterranean diet. Trial registration ClinicalTrials.gov NCT00924937 FUNDING: The study was supported by the Ministerio de Economia y Competitividad (AGL2012/39615) and by the Ministerio de Ciencia e Innovacion (PIE14/00005 and PI13/00023).

KEYWORDS:

Beta cell function; Dietary intervention; Insulin resistance; Low-fat diet; Mediterranean diet

PMID:
26474775
DOI:
10.1007/s00125-015-3776-4

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