A Randomized Controlled Trial

The Effect of Inulin on Weight Management and Ectopic Fat in Subjects With Prediabetes

Nicola D. Guess; Anne Dornhorst; Nick Oliver; Jimmy D. Bell; E. Louise Thomas; Gary S. Frost

Nutr Metab. 2015;12(36)

Conclusion

In conclusion, our findings support a role for fermentable fibres in modifying two key risk factors in diabetes development: weight management and ectopic fat deposition. Inulin, and possibly other fermentable carbohydrates, could therefore represent a potentially effective intervention at the population level.

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Trial registration
Clinical trial number: NCT01841073.

Abbreviations
ANCOVA: Analysis of covariance; BIA: Bioelectrical impedance; CPT-1b: Carnitine palmitoyltransferase 1B; CV: Coefficient of variation; FCHO: Fermentable carbohydrate; FPG: Fasting plasma glucose; GLP-1: Glucagon-like peptide 1; HOMA-IR: Homeostasis model assessment of insulin resistance; IFG: Impaired fasting glucose; IGT: Impaired glucose tolerance; IHCL: Intrahepatocellular lipid; IMCL: Intramyocellular lipid; MRI: Magnetic resonance imaging; MRS: Magnetic resonance spectroscopy; MTT: Meal tolerance test; OGTT: Oral glucose tolerance test; SCFA: Short-chain fatty acids; SEM: Standard error of the mean; tAUC: Total area under the curve; T2DM: Type 2 diabetes; VAS: Visual analogue scales; VAT: Visceral adipose tissue; 2hPG: 2 h plasma glucose.

Acknowledgements
Nicola Guess was funded by a Diabetes UK Allied Health Professional Fellowship. The Section is also funded by grants from the MRC, BBSRC, NIHR, an Integrative Mammalian Biology (IMB) Capacity Building Award, a FP7- HEALTH- 2009–241592 EuroCHIP grant and is supported by the NIHR Imperial Biomedical Research Centre Funding Scheme. Gary Frost is funded by an NIHR Senior Investigator award. This article presents independent research carried out at the NIHR/Wellcome Trust Imperial Clinical Research Facility. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The authors would like to thank Giuliana Durighel, Julie Fitzpatrick, Marina Quinlan and Catherine Holden with their assistance with the MRI studies; and also Natarin Caengprasath for assistance with screening participants and carrying out the research study days.

Table 1. Subject characteristics for each arm of the study
	Inulin (n = 20)	Cellulose (n = 19)	p value
Gender (M:F)	13:8	11:9	0.66
Age (years)	58.2 ± 12.0	59.7 ± 8.9	0.53
Weight (kg)^b	88.2 ± 14.0	83.4 ± 19.7	0.28
BMI (kg/m²)	30.8 ± 4.1	30.0 ± 2.3	0.41
FPG (mmol/L)	5.7 ± 0.5	5.9 ± 0.6	0.20
2hPG (mmol/L)	7.3 ± 2.3	7.3 ± 2.0	0.99
HbA1c (%) and (mmol/mol^a)	5.9 ± 0.1 (41.3 ± 1.4)	5.7 ± 0.1 (38.8 ± 0.9)	0.78
Fasting insulin (pmol/L)	95.4 (116.8)^b	114.1 (132.9)^b	0.17

Values are means and SD. Gender is expressed as a ratio of males to females. There were no significant differences between the groups for any of the baseline variables. FPG fasting plasma glucose; 2hPG 2-hour plasma glucose
^aSI units for HbA1c shown in brackets
^bFasting insulin was not normally distributed so values given are for median (interquartile range)