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薬理と治療
Abstract
Background and aim White rice intake is associated with higher risk of type 2 diabetes. Here, we clinically evaluated whether coingestion of persimmon leaf extract(PLE)or powder (PLP)and white rice suppresses the postprandial blood glucose(PBG)increase induced by white rice in healthy subjects. Methods In the first trial of three-treatment three-period crossover design, fasting blood glucose levels were recorded in 9 healthy subjects. Within 10 min, they ingested white rice(147 g, 50 g of carbohydrate)with one 350-mL beverage: low-dose PLE(PLE4g, from 4 g of dried leaves), high-dose PLE(PLE8g, from 8 g of dried leaves), or water with caramel color(polyphenols: 280, 560, and 0 mg, respectively). Finger-prick blood measurements at 15-120 min post-intake provided the corresponding PBG levels. In the second trial of two-treatment two-period crossover design, the PBG levels after coingestion of aqueous suspension of PLP(4 g, 292 mg of polyphenol)and white rice were measured in 15 subjects with high incremental area under the curve(IAUC)response to white rice in the same manner as the first trial. In in vitro digestion methods, suppressive effect of persimmon leaf polyphenols on the digestion of starchy food materials were investigated. Results In the first trial, the PBG levels at 30 min post-intake were significantly lower with PLE4g and PLE8g coingestion compared with the control(136.9±19.5 and 130.7±24.2 mg╱dL vs. 142.7±23.2 mg╱dL, P=0.036 and 0.009, respectively). Strong negative correlations were found between IAUC of white rice and water group and the delta IAUC values in the PLE4g and PLE8g coingestion groups, indicating that PLE coingestion resulted in a larger IAUC reduction in participants with a higher IAUC response to white rice. Subgroup analysis revealed the values of PGE levels, the delta, and IAUC were significantly lower in both groups of PLE4g and PLE8g coingestion than in the control group of high IAUC responder subgroups(n=5), but no significant difference was evident in a PLE4g group of the low-responder subgroup(n=4). In the second trial using 15 subjects with high IAUC responses to white rice, PLP(4 g)coingestion caused significant suppression in the responses of the PBG levels, the delta, and IAUC compared with the control. In in vitro digestion of five kinds of starchy food materials including rice flour, the glucose liberation were found to be suppressed to the same degree in the presence of PLE or PLP. Conclusions Coingestion of white rice and PLE(from 4 g of dried leaves)or PLP (4 g)suppressed PBG elevation compared with white rice and H2O, and the suppressive effect was particularly prominent in high IAUC responders to white rice.
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