代谢综合征三大产能营养素比例分段调整方法  

Segmentation adjustment method of three capacity nutrients ratio of metabolic syndrome patients

作　　者：吕阳梅 缪艳霞 乔良美 张瑞娟[2] 张路钱 池方方 南静[2] 周玲[2] 

机构地区：[1]西安交通大学医学部附属西安市中心医院营养科,710003 [2]西安交通大学公共卫生学院,710003

出　　处：《中华临床营养杂志》2017年第5期296-301,共6页Chinese Journal of Clinical Nutrition

基　　金：国家自然科学基金（81273051）

摘　　要：目的 针对目前国内外代谢综合征（MS）三大营养素所占能量比例研究的不足,探讨一种三大产能营养素比例分段调整方法.方法 选择2013年5月至2015年12月在西安交通大学医学部附属西安市中心医院体检中心、内分泌科、营养科的MS患者334例,根据计算器随机数字法,将患者分为干预组（n=168）和对照组（n=166）.两组能量均按照以下公式计算：y=13.5-0.025x1（年龄）＋0.215x2（活动系数）-0.006x3（腰围）＋0.342x4（气温）-0.268x5（体质量指数）＋0.623x6（性别）.能量限定为5.02～7.53 MJ.干预组不同能量段进行三大营养素供能比调整：每日能量为5.02 MJ时：蛋白质供能比为30％,能量每增加0.42 MJ,供能比减少2.5％;碳水化合物供能比为40％,能量每增加0.42 MJ,供能比增加2.5％.脂肪供能比在各个能量阶段均为30％.对照组三大营养素所占能量比例均按照蛋白质15％、脂肪25％、碳水化合物60％.结果 干预组干预后6个月,餐后2h血糖由干预前的（9.22±5.57） mmol/L下降到（6.05±4.68） mmol/L,糖化血红蛋白（HbAlc）由干预前的（6.79±1.12）％下降到（5.56±1.32）％,三酰甘油由干预前的（3.14±1.73） mmol/L下降到（1.72±1.17） mmol/L,与对照组同期对比,差异均有统计学意义（P=0.000、0.02 7、0.034）.结论 MS三大营养素比例分段调整方法能显著改善MS患者的糖脂代谢指标.Objective To explore a method of subsection adjustment for the proportion of three capacity nutrients in patients with metabolic syndrome （MS）.Methods Totally 334 MS patients who were diagnosed in the physical examination center and the department of endocrinology and nutrition of Xi＆#39;an Central Hospital Affiliated to Xi＆#39;an Jiaotong University of School of Medicine were enrolled in this study.According to calculator random digital method,the patients were divided into intervention group （n=168） and the control group （n=166）.The energy of two groups were calculated according to the following formula,y =13.5-0.025x1 ＋ 0.215x2-0.006x3＋0.342x4-0.268x5＋0.623x6 （x1：age,x2：activity intensity index,x3：waist circumference,x4：environmental temperature,x5：BMI,x6：sex）.The limit of daily energy was set to 5.02-7.53 MJ.The proportion of the three major nutrients for energy was adjusted of different energy segments of intervention group.When the daily energy was 5.02 MJ,the protein energy ratio was 30%,and the energy increased by 0.42 MJ per time while the protein energy supply ratio was reduced by 2.5%.The energy ratio of carbohydrate was 40%,and the energy increased 0.42 MJ per time while the energy ratio increased by 2.5%.The energy ratio of fat was 30% on various stages of energy supply.The energy proportions of the three major nutrients in the control group were as follows：protein 15%,fat 25%,and carbohydrate 60%.Results After the intervention by 6 months,the 2-hour postprandial blood glucose of intervention group decreased from （9.22±5.57） mmol/L to （6.05±4.68） mmol/L,the hemoglobin A 1 c decreased from （6.79 ± 1.12） % to （5.56± 1.32） %,and the triglyceride decreased from （3.14±1.73） mmol/L to （1.72±1.17） mmol/L.There was significant difference compared with those in control group （P =0.000,0.027,0.034）.Conclusion The proportions of the three major nutrients in MS can remarkably improve the glucose and lipid metabolism in MS patients.

关 键 词：代谢综合征 产能营养素 比例 

分 类 号：R589[医药卫生—内分泌]