作者投稿
专家审稿
编辑办公
邮件订阅
RSS
Influence of Different Staple Food Compositions on Blood Glucose and Lipid in Patients with Type 2 Diabetes Mellitus
-
摘要:
目的 比较添加药食同源谷物粉与小麦膳食纤维的主食对2型糖尿病患者血糖控制的影响。 方法 120例2型糖尿病患者参与本研究, 按2:1比例随机分为研究组(80例)和对照组(40例), 分别使用添加药食同源谷物粉和小麦膳食纤维的馒头替换主食, 持续13周。比较不同饮食干预前后人体测量、生化检查、血糖及胰岛素水平等指标变化。 结果 与对照组相比, 研究组患者舒张压(-0.05 mm Hg比0 mm Hg, P=0.021)、甘油三酯(-0.10 mmol/L比0.27 mmol/L, P=0.040)、空腹及餐后2 h胰岛素水平(-1.30 mU/L比0.62 mU/L, P=0.001;-14.82 mU/L比-3.93 mU/L, P=0.020)的改善效果更为显著, 而对照组患者较研究组腰围降低幅度更大(-5.00 cm比-4.00 cm, P=0.001), 两组间体重、臀围、收缩压、糖耐量干预前后变化的差异不具有统计学意义(P > 0.05)。 结论 添加药食同源谷物粉主食与小麦膳食纤维主食相比, 可更显著地降低2型糖尿病患者甘油三酯及胰岛素水平, 添加小麦膳食纤维主食在降低腰围方面效果更明显。 Abstract:Objective To compare the effect of staple food containing edible medicinal foods versus wheat fiber on blood glucose control in patients with type 2 diabetes mellitus. Methods We recruited 120 patients with type 2 diabetes mellitus into this study, and randomly divided them into 2 groups (80 participants in the study group and 40 in the control group). The staple food in the study group was steamed bread with wheat flour and flour of several kinds of edible medicinal foods, and in the control was steamed bread with wheat flour and wheat fiber. The study lasted for 13 weeks. The changes of anthropometry, biochemical tests, blood glucose and insulin levels before and after the dietary intervention were compared between the two groups. Results Compared with the control group, patients in the study group showed more remarkable improvement in diastolic blood pressure(-0.05 mm Hg vs. 0 mm Hg, P=0.021), triglyceride level (-0.10 mmol/L vs. 0.27 mmol/L, P=0.040), fasting and 2-hour postprandial blood insulin levels (-1.30 mU/L vs. 0.62 mU/L, P=0.001; -14.82 mU/L vs. -3.93 mU/L, P=0.020).The patients in the control group had a larger reduction in waistcircumference compared with the study group(-5.00 cm vs. -4.00 cm, P=0.001). There was no significant inter-group difference in changes of body weight, hip circumference, systolic blood pressure, or glucose tolerance (P > 0.05). Conclusions Compared with wheat fiber, staple food containing wheat flour and edible medicinal foods can reduce triglyceride and insulin levels more significantly in patients of type 2 diabetes mellitus, while staple food supplemented with wheat fiber has a more obvious effect on waist circumference. -
表 1 研究组及对照组主食营养成分含量表
主食 重量
(g)能量
(kJ)蛋白质
(g)脂肪
(g)碳水化合物
(g)特膳馒头 50.00 772.70 8.38 1.16 34.80 小麦膳食纤维馒头 50.00 674.92 6.55 1.10 35.05 
下载: 导出CSV
表 2 两组糖尿病患者人口统计学基线资料
组别 年龄
[M(Q1，Q3), 岁]身高
(x±s, cm)体重
(x±s, kg)对照组(n=40) 64(55, 66.75) 160.48±7.81 68.33±11.45 研究组(n=80) 58(50, 66) 164.46±9.11 72.80±12.27 t值 2.37 1.93 P值 0.116 0.125 0.960
下载: 导出CSV
表 3 两组糖尿病患者体重、腰围、臀围差值比较[M(Q1，Q3)]
组别 体重(kg) 腰围(cm) 臀围(cm) 对照组(n=40) -2.50(-3.00, -2.50) -5.00(-5.75, -4.00) -3.00(-4.00, -2.00) 研究组(n=80) -2.50(-3.00, -2.00) -4.00(-4.00, -3.00) -3.00(4.00, -3.00) P值 0.320 0.001 0.299
下载: 导出CSV
表 4 两组糖尿病患者血压差值比较[M(Q1，Q3), mm Hg]
组别 收缩压 舒张压 对照组(n=40) -10.00(-20.00, 0) 0(-5.00, 0) 研究组(n=80) -7.50(-10.00, 0) -5.00(-10.00, 0) P值 0.311 0.021 1 mm Hg=0.133 kPa
下载: 导出CSV
表 5 两组糖尿病患者糖化血红蛋白及血脂差值比较[M(Q1，Q3)]
组别 糖化血红蛋白(%) TC(mmol/L) TG(mmol/L) HDL-c(mmol/L) LDL-c(mmol/L) 对照组(n=40) -0.15(-0.85, 0.38) -0.31(-0.68, 0.08) 0.27(0.02, 0.80) -0.17(-0.30, -0.02) -0.18(-0.48, 0.12) 研究组(n=80) -0.10(-0.50, 0.28) -0.22(-0.77, 0.19) -0.10(-0.64, 0.56) -0.03(-0.15, 0.06) -0.09(-0.50, 0.30) P值 0.696 0.437 0.040 0.006 0.650 TC:总胆固醇；TG：甘油三酯；HDL-c:高密度脂蛋白胆固醇；LDL-c:低密度脂蛋白胆固醇
下载: 导出CSV
表 6 两组糖尿病患者不同时间点血糖差值比较[M(Q1，Q3), mmol/L]
组别 空腹 餐后0.5 h 餐后1 h 餐后2 h 对照组(n=40) -0.65(-2.40, 0.28) -0.95(-1.95, 1.03) -0.95(-2.25, 0.93) -1.95(-4.50, 0.65) 研究组(n=80) -0.30(-1.40, 0.65) -0.65(-1.90, 0.70) -1.30(-3.00, 0.78) -2.75(-4.80, -0.20) P值 0.327 0.973 0.585 0.478
下载: 导出CSV
表 7 两组糖尿病患者不同时间点胰岛素差值比较[M(Q1，Q3), mU/L]
组别 空腹 餐后0.5 h 餐后1 h 餐后2 h 对照组(n=40) 0.62(-1.28, 3.73) 0.31(-10.58, 9.00) -0.47(-12.47, 9.34) -3.93(-18.51, 10.18) 研究组(n=80) -1.30(-4.82, 0.71) -1.06(-11.18, 7.00) -3.74(-23.11, 6.81) -14.82(-37.95, -0.65) P值 0.001 0.593 0.340 0.020
下载: 导出CSV
-
[1] Guariguata L, Whiting DR, Hambleton I, et al. Global estimates of diabetes prevalence for 2013 and projections for 2035[J]. Diabetes Res Clin Pr, 2014, 103:137-149. doi: 10.1016/j.diabres.2013.11.002 [2] Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China[J]. New Engl J Med, 2010, 362:1090-1101. doi: 10.1056/NEJMoa0908292 [3] Burger KN, Beulens JW, van der Schouw YT, et al. Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus[J]. PLoS One, 2012, 7:e43127. doi: 10.1371/journal.pone.0043127 [4] Hu FB, van Dam RM, Liu S. Diet and risk of Type Ⅱ diabetes:the role of types of fat and carbohydrate[J]. Diabetologia, 2001, 44:805-817. doi: 10.1007/s001250100547 [5] Sluijs I, van der Schouw YT, van der A DL, et al. Carbohydrate quantity and quality and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) study[J]. Am J Clin Nutr, 2010, 92:905-911. doi: 10.3945/ajcn.2010.29620 [6] 刘月冉, 耿越.植物多糖降血糖作用机制研究[J].食品与药品, 2012, 14:64-67. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=sdspkj201201019 [7] 李晓东, 李娟, 杨丽霞, 等.中药植物多糖降血糖作用的研究进展[J].西部中医药, 2010, 23:77-80. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=gszy201011038 [8] Silva FM, Kramer CK, Almeida JCD, et al. Fiber intake and glycemic control in patients with type 2 diabetes mellitus:a systematic review with meta-analysis of randomized controlled trials[J]. Nutr Rev, 2013, 71:790-801. doi: 10.1111/nure.12076 [9] Post RE, Mainous AG 3rd, King DE, et al. Dietary fiber for the treatment of type 2 diabetes mellitus:a meta-analysis[J]. J Am Board Fam Med, 2012, 25:16-23. doi: 10.3122/jabfm.2012.01.110148 [10] Chandalia M, Garg A, Lutjohann D, et al. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus[J]. New Engl J Med, 2000, 342:1392-1398. doi: 10.1056/NEJM200005113421903 [11] Du H, van der A DL, Boshuizen HC, et al. Dietary fiber and subsequent changes in body weight and waist circumference in European men and women[J]. Am J Clin Nutr, 2010, 91:329-336. doi: 10.3945/ajcn.2009.28191 [12] Byrd-Williams CE, Strother ML, Kelly LA, et al. Dietary fiber and associations with adiposity and fasting insulin among college students with plausible dietary reports[J]. Nutrition, 2009, 25:896-904. doi: 10.1016/j.nut.2009.02.003 [13] Maki KC, Beiseigel JM, Jonnalagadda SS, et al. Whole-grain ready-to-eat oat cereal, as part of a dietary program for weight loss, reduces low-density lipoprotein cholesterol in adults with overweight and obesity more than a dietary program including low-fiber control foods[J]. J Am Diet Assoc, 2010, 110:205-214. doi: 10.1016/j.jada.2009.10.037 [14] Ben Slama F, Jebali N, Chemli R, et al. Dietary fiber in the diets of urban Tunisian women:association of fiber intake with BMI, waist circumference and blood chemistry:preliminary study[J]. Clin Res Hepatol Gastroenterol, 2011, 35:750-754. doi: 10.1016/j.clinre.2011.04.005 [15] Fujii H, Iwase M, Ohkuma T, et al. Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus:the Fukuoka Diabetes Registry[J]. Nutr J, 2013:159:2114-2126. [16] 廖冬冬, 林文庭.植物多糖降血糖作用机制的研究进展[J].海峡预防医学杂志, 2012, 18:26-28. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=hxyfyxzz201202012 [17] 陶利, 柳园, 胡德群, 等.主食替换对2型糖尿病患者餐后血糖的影响[J].预防医学情报杂志, 2013, 29:196-199. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=yfyxqbzz201303007 [18] 袁媛, 陈立勇.药食同源组方主食对住院2型糖尿病患者疗效的实验研究[J].慢性病学杂志, 2013, 14:172-174. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=8260342 [19] 廖锦芳, 黄秋云, 江映红, 等.主食药膳在糖尿病治疗中的研究与应用[J].中医临床研究, 2012, 4:22-23 http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zylcyj201202014 -
点击查看大图
表(7)
计量
- 文章访问数: 94
- HTML全文浏览量: 20
- PDF下载量: 14
- 被引次数: 0
