膳食营养干预对老年糖尿病患者糖脂代谢和抗氧化能力影响研究  

Influence of dietary nutrition intervention on glucolipid metabolism and antioxidation ability of elderly type II diabetic patients

作　　者：孙建琴[1] 陈艳秋[1] 宗敏[1] 张鑫毅[1] 孙寿娟[1] 吴玉苗[2] 杨柯君[2] 陈茂芳[3] 陈爱芳[3] 冯颖[1] 汤丽新[1] 李臻[1] 华莉[1] 陈霞飞[1] 

机构地区：[1]复旦大学附属华东医院营养科,上海市200040 [2]上海市静安区石门二路社区卫生服务中心,200043 [3]上海市静安区曹家渡社区卫生服务中心,200045

出　　处：《老年医学与保健》2008年第2期91-94,99,共5页Geriatrics & Health Care

基　　金：国家自然科学基金(基金编号:30371221);上海市科委基金(基金编号:034119855)

摘　　要：目的研究膳食营养干预对老年糖尿病患者糖脂代谢和体内抗氧化能力的影响。方法43名超重或肥胖的老年2型糖尿病患者,采用随机交叉试验(cross-over study)随机分配至以低血糖指数为特征的膳食营养干预组(试验组)和普通膳食营养干预组(对照组),每种膳食分别连续使用4周,间隔洗脱期4周,测定试验前后糖脂代谢谱和抗氧化指标的变化。结果试验组和对照组的血清胰岛素分别降低20.3%、5.5%,HOMA胰岛素抵抗指数分别下降33.3%、17.5%,两组间下降幅度差异有统计学意义(P<0.05),试验组和对照组的空腹静脉血糖分别下降16.8%、13.9%,果糖胺分别下降6.3%、4.3%,两组间下降幅度差异无统计学意义(P>0.05);试验组和对照组的甘油三酯分别下降28.6%、18.3%,两组间差异无统计学意义(P>0.05);试验组低密度脂蛋白下降17.2%,对照组低密度脂蛋白上升4.4%,两组间下降幅度差异有统计学意义(P<0.01);试验组和对照组的SOD分别升高了15.68%、21.33%,MDA分别下降23.94%、21.55%,GSH-PX分别升高了15.74%、17.09%,两组间的MDA差异有统计学意义(P<0.05),而SOD和GSH-PX两组间差异无统计学意义(P>0.05)。结论在控制总能量基础上,采用低GI的营养治疗策略更有助于改善病人糖脂代谢和氧化应激水平。Objective A randomized cross-over study was performed to compare the influence of low glycemic index （LGI） diets aod high glycemic index （HGI） diets on blood glucose and lipid profiles, and see whether LGI diets could improve oxidative stress in elderly type 2 diabetic patients. Methods In this randomized cross-over study, 43 obese or overweight elderly patients with lype Ⅱ diabetes were randomized to Ihe IGI glnup and HGI group with two 4-week periods with a d-week washout period. Fasting venous blood samples and anthropometric assessments and oridative stress signs were taken at the haseline and after the trial at each period to compare changes in glucolipid metabolism and antioxidation indexes. Results After the trial , the tasting serum insnlin and Homa-IR-index in the LGI group decreased by 20.3% and 33.3% respectively versus 5.5% and 17.5% in the HGI group, the difference being significant（p〈0.05）; serum TG decreased by 28.6% versus 18.3%; LDL-C decreased by 17.2% in the LGI group , while it increased by 4.4% in the HGI group （P〈0.01）; SOD increased by 15.68% versus 21.33%; GSH-PX increased by 15.74% versus 17.09%： MDA decreased by 23.94% versus 21.55% （P〈0.05）. There was no significant difference in SOD and GSH-PX between the two groups. Conclusions On condition that the total energy is welt controlled, low GI diet intake helps improve glucolipid metaholism and oxidative stress in elderly type 2 diabetic patients.

关 键 词：膳食 干预性研究 糖尿病 2型 糖脂类 抗氧化能力 

分 类 号：R587.1[医药卫生—内分泌]