Prediabetes as precursor of diabetes is characterized by a disorder in glucose metabolism, but is often associated with an impaired fat metabolism, too, defined by higher serum levels of cholesterol and/or triglycerides. Hyperlipidemia and a poor LDL/HDL ratio represent important risk factors for cardiovascular diseases. The risk is even higher in presence of NAFLD, a common comorbidity in subjects with (pre-)diabetes. Thus, amelioration of these metabolic disorders is important. Both hyperglycemia and hyperlipidemia can initially be treated by dietary approaches. Low-fat diets, but possibly even more low-carb diets seem to improve metabolic parameters.

Thus, we compare the effect of a low-carb or low-fat diet in subjects with prediabetes, focusing on predefined lipid parameters and liver fat, investigating possible mechanisms by which cardiometabolic risk factors can be reduced.

Our analysis is conducted within a preliminary sample of the ongoing DiNA-P (Diabetes Nutrition Algorithms in Prediabetes) study, covering 12 months of dietary intervention in 176 subjects of which 155 completed the study by now. Lipid metabolism is assessed by total cholesterol, LDL, HDL, LDL/HDL ratio and triglyceride serum levels, liver fat by magnetic resonance spectroscopy. Statistical analysis is based on within-group and between-group comparisons as well as non-parametric correlation analysis (Spearman). Level of significance is p<0,05.

Within the low-fat group, an improvement in all lipid parameters except for HDL cholesterol can be stated. Also, the LDL/HDL ratio as well as liver fat content were reduced in the end of the study. Within the low-carb group, the same favorable development was observed. Additionally, HDL-cholesterol showed a significant improvement, resulting in a significantly different development of HDL cholesterol in the low-carb group compared to low-fat. Our findings are confirmed by subgroup analysis, stratified by use of lipid lowering medication.


N. Meyer: None. L. Diekmann: None. S. Kabisch: Research Support; Self; California Walnut Commission, Institute for Grain Processing, Nuthetal, J. Rettenmaier Söhne, Südzucker / Beneo. Other Relationship; Self; Berlin-Chemie AG, Sanofi. U. Dambeck: None. A.F. Pfeiffer: Advisory Panel; Self; Abbott, Berlin-Chemie AG, Novo Nordisk A/S. Speaker's Bureau; Self; Lilly Diabetes, Novartis AG, Sanofi-Aventis Deutschland GmbH.

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