Anales de la RANM

27 A N A L E S R A N M R E V I S T A F U N D A D A E N 1 8 7 9 S U P L E M E N T O I SIMPOSIO · JÓVENES INVESTIGADORES Libro de Abstracts An RANM. 2021;138(03).supl01: 27 - 54 diversos mecanismos de acción, como la inhibi- ción de enzimas digestivas, o la estimulación de la secreción de insulina. Para probar los efectos de los polifenoles de la dieta -concretamente flavanoles de alto peso molecular- en el metabolismo postprandial de sujetos con DMT2, se ha diseñado un producto fácilmente incorporable a la dieta habitual. Se trata de una mezcla de cacao puro y harina de algarroba en una proporción 60:40. Presenta un alto contenido en polifenoles (16,7 ± 0,6 g/100 g), donde aproxima- damente el 70% son flavanoles, y en fibra dietética (55,7 + 0,9 g/100 g). El producto se ha validado en un análisis sensorial hedónico ( n =100) donde se comparó con otros preparados comerciales con distintos porcentajes de cacao (22%, 70% y 100%). En este análisis, la mezcla de cacao y algarroba fue calificada como aceptable, con puntuaciones en algunos parámetros similares a las de productos comerciales, aumentando la calificación al realizar un segundo análisis sensorial en el que se propor- cionaba información adicional sobre sus posibles efectos en salud. Esta mezcla de cacao y algarroba será evaluada en un ensayo clínico nutricional aleatori- zado y cruzado con un tamaño muestral de 25 sujetos (variable principal, insulina postpran- dial). En el ensayo se recogerán muestras de sangre, orina y heces -además de cuestionarios de saciedad- con objeto de estudiar las modifi- caciones postprandiales a) tras un desayuno rico en grasa y azúcares (control); b) tras ingerir al mismo tiempo el desayuno y el producto; y c) tras tomar el producto diez horas antes del desayuno (asociadas al efecto de los metabolitos colónicos). El ensayo clínico está actualmente en fase de reclutamiento, habiéndose inscrito hasta el momento doce sujetos con las siguientes características basales (media + DS): edad, 60,5 + 5,1 años; índice de masa corporal, 31,1 + 3,2 kg/m 2 ; hemoglobina glicosilada, 6,1 + 0,4 %; todos ellos siguiendo tratamiento exclusivo con metformina como antidiabético. Se espera que este ensayo clínico aporte resultados preliminares sobre el potencial de los polifenoles de alto peso molecular en la modula- ción de las alteraciones postprandiales presentes en la DMT2. Agradecimientos: Agencia Estatal de Investi- gación (RTI2018-095059-B-I00), con cofinan- ciación de fondos FEDER (UE). Consejería de Educación, Juventud y Deporte de la Comunidad de Madrid y Fondo Social Europeo (PEJ-2020-AI/ BIO-18529). Type 2 diabetes mellitus (T2DM) has become the metabolic disease with the highest worldwide prevalence. Its development is mainly due to defects in the secretion or action of insulin. This causes chronic hyperglycaemia, whose bad control may originate alterations in lipid profile (increase in triglycerides and sometimes also in LDL cholesterol, together with a decrease in HDL cholesterol), together with inflammation and oxidative stress, processes that are exacer- bated in the postprandial state. At present, there is great interest in the study of dietary approaches to delay or modulate the alterations associated with this pathology. In this context, polyphe- nols are antioxidant compounds present in foods of plant origin, with growing evidence on their potential (as intact compounds and as metabo- lites generated by the intestinal microbiota) for modulating T2DM by various mechanisms of action, such as such as the inhibition of digestive enzymes, or the stimulation of insulin secretion, among others. In order to evaluate the effects of dietary polyphe- nols - specifically high molecular weight flavanols - on the postprandial metabolism of subjects with T2DM, a product easily incorporated into the usual diet was designed. It is a mixture of pure cocoa and carob flour in a 60:40 ratio. It has a high content in polyphenols (16.7 ± 0.6 g / 100 g), where approximately 70% are flavanols, and in dietary fiber (55.7 + 0.9 g / 100 g). The product was validated in a hedonic sensory analysis ( n = 100) where it was compared with other commer- cial preparations with different percentages of cocoa (22%, 70% and 100%). In this analysis, the cocoa and carob mixture was rated as acceptable, with scores in some parameters similar to those of commercial products. Indeed, the rating was increased when performing a second sensory analysis in which additional information was provided on the potential health effects of the product. This cocoa-carob mixture will be evaluated in a randomized, crossover nutritional clinical trial. For this, a sample size of 25 subjects has been established, taking postprandial insulin as the primary outcome. In the trial, blood, urine and faecal samples will be collected -in addition to satiety questionnaires- in order to study postpran- dial modifications a) after a high-fat high-sugar breakfast (control); b) after eating breakfast and the product at the same time; and c) after taking the product ten hours before breakfast (associ- ated with the effect of the colonic metabolites). The clinical trial is currently in the recruitment phase, having enrolled twelve subjects with the following baseline characteristics (mean + SD): age, 60.5 + 5.1 years; body mass index, 31.1 + 3.2 kg / m 2 ; glycated haemoglobin, 6.1 + 0.4%; all of them following exclusive treatment with metformin as antidiabetic drug. This clinical trial is expected to provide prelim- inary results on the potential of high molecular weight polyphenols in modulating postprandial changes in T2DM. Acknowledgments : Spanish Research Agency (RTI2018-095059-B-I00), with co-funding from FEDER funds (EU). Department of Education, Youth and Sports of Madrid Region (CM) and European Social Fund (PEJ-2020-AI/BIO-18529).