膳食联合生活方式干预对糖调节受损患者氧化应激水平和血糖转归的影响  

EFFECT OF LIFESTYLE COMBINED WITH DIETARY INTERVENTION ON OXIDATIVE STRESS AND CONVERSION OF BLOOD GLUCOSE IN PATIENTS WITH IMPAIRED GLUCOSE REGULATION

作　　者：徐丹凤[1] 孙建琴[1] 陈敏[1] 陈艳秋[1] 孙玮[2] 唐倩如 

机构地区：[1]复旦大学附属华东医院临床营养中心,上海200040 [2]上海市静安区曹家渡社区卫生服务中心,上海200040 [3]上海市静安区静安寺社区卫生服务中心,上海200040

出　　处：《营养学报》2014年第3期224-228,共5页Acta Nutrimenta Sinica

基　　金：上海市卫生局科研课题基金(No.2007168);上海市科委科研计划课题基金(No.07ZR14036)

摘　　要：目的探讨膳食替代治疗联合生活方式干预对糖调节受损(impaired glucose regulation,IGR)患者的氧化应激水平和营养状况的影响。方法从社区招募IGR患者,随机分入干预组(n=46)和对照组(n=42)。采用随机对照临床试验,为期12个月,基线时两组受试者均接受健康教育和糖尿病防治宣教。此外,干预组还接受两阶段的综合干预,在干预第1～3月,受试者接受膳食替代干预和生活方式干预;干预第4～12月,每月随访一次,了解受试者的血糖和饮食变化情况。结果干预组受试者的体重减轻大于对照组[(-1.8±2.2)kg vs.(-0.6±2.5)kg,P<0.05],主要表现为体脂重量减少。干预前后两组受试者的LDL-C、空腹血糖、餐后2h血糖和HbA1c水平变化有显著性差异(P<0.05或P<0.01)。与基线水平相比,干预组受试者的SOD升高6.15 U/ml,而对照组降低16.71 U/ml(P<0.05)。干预前后各组之间膳食营养素摄入量的变化无显著改变(P>0.05)。但与基线水平相比,干预组受试者的钙、铁、维生素A和维生素B2的水平增高(P<0.05或P<0.01)。干预组有39.0%患者的血糖转归到正常水平,对照组的转归率仅有7.5%,两组的转归率有显著差异(P<0.01)。结论采用的膳食替代联合生活方式干预能改善IGR患者的体重、糖脂代谢和氧化应激水平,有效地提高IGR患者的膳食营养状况,有利于IGR患者的血糖转归到正常水平,因此膳食替代联合生活方式干预可作为促进糖调节受损转归的有效措施。Objective To evaluate the impact of a lifestyle intervention program combined with daily low-glycemic index meal replacement, on oxidative stress and nutritional status in impaired glucose regulation（IGR） patients. Methods Subjects with IGR were recruited from two communities and randomly assigned to an intervention group（n=46） and control group（n=42）. Both groups received health and diabetes prevention and treatmant counseling at baseline. The intervention group also received a daily meal replacement and intensive lifestyle intervention to promote healthy eating habits during the first 3 mo of the study, and follow-up visits were performed monthly until the end of one-year study. Results Body weight loss after one year was significant in the intervention group compared to the control group（-1.8±2.2） kg vs.（-0.6±2.5） kg,（P〈0.05）, mainly due to reduced body fat mass. At the end of the study, LDL-C, fasting plasma glucose, 2-h postprandial plasma glucose and HbA1c levels were significantly reduced in the intervention group compared to those in the control group（P〈0.05 or P〈0.01）. The SOD activity increased 6.15 U/ml in the intervention group and decreased 16.71 U/ml in the control group（P〈0.05） compared to their baseline values respectively. There was no difference on nutrient intake levels between two groups. Compared to baseline, the intakes of calcium, iron, VA and VB2 in the intervention group showed significant improvement（P〈0.05 or P〈0.01）. The incidence of normal glucose regulation（NGR） in the two groups was significantly different（P 0.001）. Conclusion Treatment with regular contact, lifestyle advice and low-glycaemic index meal replacements was an effective approach in improving nutrient intake, oxidative stress, weight loss, glycaemic control and normalization of impaired glucose metabolism in IGR patients over 1-year period.

关 键 词：糖调节受损 膳食替代 氧化应激 营养状况 

分 类 号：R587.1[医药卫生—内分泌]