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饮食干预对肥胖型2型糖尿病患者血脂紊乱的影响(1)
http://www.100md.com 2008年11月15日 《中国实用医药》 2008年第31期
     【摘要】 目的 了解饮食干预对肥胖型2型糖尿病患者血脂紊乱的影响,以提供更合理的营养治疗方法。方法 选择2006年5月至2008年3月在内分泌科门诊就诊的肥胖型2型糖尿病患者80例,按患者就诊顺序编号按1∶1比例随机入组,治疗组、对照组各40例。治疗组食用依据由营养师制订食谱的要求制作的称重膳食,对照组自己控制饮食。观察2组患者膳食中热能和部分营养素的摄入情况比较以及治疗前后两组患者血糖和血脂的变化。结果 对照组热能、三大产热营养素及胆固醇的摄入明显较高, 而膳食纤维的摄入量明显较低,而脂肪的摄入量明显较高,占总热能的36%;脂肪来源中饱和脂肪酸、多不饱和脂肪酸及单不饱和脂肪酸所占总能量的比例分别为14. 2%、13.1% 和8.7%,与治疗组同项比较,差异均有统计学意义(P<0. 01)。治疗组在治疗后空腹血糖(FBG)、体重指数(BMI)、总胆固醇(TC)、三酰甘油 (TG)及低密度脂蛋白(LDL)均有明显下降, 高密度脂蛋白(HDL)显著增高,差异均有统计学意义(P<0.05或P<0.01);而对照组在治疗后FBG、BMI、TC、TG、LDL及HDL的变化均不明显 (P>0.05)。结论 营养干预能显著地降低患者的体质量,改善患者的脂代谢紊乱。
, 百拇医药
    【关键词】饮食干预;肥胖;2型糖尿病;血脂紊乱

    The effect of dietary intervention on lipid disorders in obese patients with type 2 diabetes RAN Jun-hua, LIU Hui.

    st Affiliated Hospital of Xinxiang Medical college,Weihui 453100,China

    

    【Abstract】 Objective To study the effect of dietary intervention on lipid disorders in obese patients with the type 2 diabetes in order to provide a more reasonable nutrition therapy. Methods A total of 80 obese subjects with the type 2 diabetes were randomly allocated into two groups according to the attendance serial numbers. The test group was provided with weighed individual diabetic food according to the recipes made by the nutritionist and the control group went on diet dominated by themselves. Outcomes were assessed by various nutrients the patients took in and the changes of blood glucose and lipid. Results The calories, protein, fat, carbohydrate and cholesterol were obviously higher that the control group actually took in. But more fat was taken in with the percent of 36% of the calories. The percent the saturated fatty acid, the multi-unsaturated fatty acid and the single unsaturated fatty acid was taken in was respectively 14.2%, 13.1% and 8.7% of the calories, and the difference had the statistics significance compared with the same item in the treatment group. fasting blood glucose (FBG),body mass index (BMI),Total cholesterol (TC),triglycerides (TG),low density lipoprotein (LDL) in the treatment group significantly decreased and high density lipoprotein (HDL) significantly increased after the treatment(P<0. 01) while those in the control group had no significant changes after treatment (P>0. 05). Conclusion The nutrition intervention could obviously reduce patient's body mass index and improves patient's fat metabolic disorder.
, 百拇医药
    【Key words】Nutrition intervention; Obese; Type 2 diabetes; Blood lipid disorder

    肥胖常并发2型糖尿病和血脂代谢紊乱,是引发胰岛素抵抗(IR)的主要因素,而IR则是2型糖尿病和脂代谢紊乱发生的始动因素[1]。血脂紊乱是造成动脉粥样硬化(AS)的重要原因之一,从而导致冠心病、脑血管病,最终导致糖尿病患者死亡。因此,在肥胖型2型糖尿病患者治疗过程中,纠正脂质代谢紊乱,使其恢复至正常范围,显得极为重要。为了解饮食干预对肥胖型2型糖尿病患者血脂紊乱的影响,本文进行了如下研究。

    1 临床资料

    1.1 一般资料 选择自2006年5月至2008年3月在内分泌科门诊就诊的肥胖型2型糖尿病患者,共80例。根据患者就诊顺序编号按1∶1比例随机入组,治疗组、对照组各40例。治疗组男19例,女21例,平均(47.30±6.14)岁,平均病程(3.98±1.09)年;对照组男21例,女19例,平均年龄(46.10±7.28)岁,平均病程(3.87±1.78)年。两组性别、病程、年龄、血糖、BMI以及各项血脂指标治疗前等比较差异均无统计学意义(P>0.05),具有可比性。

    1.2 诊断标准及排除标准 糖尿病的诊断采用1999年WHO诊断标准[2](静脉血浆真糖法):有糖尿病症状,任何时间血糖≥11.l mmol/L(200 mg/dl)或空腹血糖 ≥7.0 mmol/L(126 mg/dl);有糖尿病症状而血糖未达上述标准,进行75 g口服葡萄糖耐糖量观察(OGTT),2 h血糖≥11.l mmol/L(200 mg/dl)。肥胖的诊断参照亚太地区成人肥胖标准,即BMI>25,计算公式为BMI=体质量(kg)/身高(m2)。

    , http://www.100md.com(冉君花 刘 辉)
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