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Influence of Different Staple Food Compositions on Blood Glucose and Lipid in Patients with Type 2 Diabetes Mellitus
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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 
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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
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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
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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
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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
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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
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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
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