北京市和太原市2型糖尿病患者饮食特点与营养指导调查  

Investigation of Dietary Characteristics and Nutritional Guidance of Patients with Type 2 Diabetes in Beijing and Taiyuan

作　　者：安凌王 王丹丹[2] 师晓嵘 陈林慧 李香兰 季宇 AN Lingwang;WANG Dandan;SHI Xiaorong;CHEN Linhui;LI Xianglan;JI Yu(Department of Endocrinology,Taiyuan Diabetes Hospital,Taiyuan 030013,China;Department of Endocrinology,Beijing Ruijing Diabetes Hospital,Beijing 100079,China;Department of Endocrinology,Beijing Aerospace General Hospital,Beijing 100076,China)

机构地区：[1]太原糖尿病专科医院内分泌科,太原030013 [2]北京瑞京糖尿病医院内分泌科,北京100079 [3]北京航天总医院内分泌科,北京100076

出　　处：《宁夏医科大学学报》2022年第3期276-280,285,共6页Journal of Ningxia Medical University

基　　金：北京市丰台区卫生健康系统立项(2017-81)。

摘　　要：目的 分析北京、太原两城市不同慢性肾脏病(CKD)危险分层的2型糖尿病(T2D)患者饮食特点及所接受的营养建议,了解临床营养实践与指南的差距。方法 回顾性分析自2018年3月至2019年12月在北京瑞京糖尿病医院和太原糖尿病专科医院就诊并接受专业营养师评估的T2D患者。采用问卷调查方式采集患者一般信息,膳食回顾法评估患者食物摄入状况。结果 共1 194例患者入选,北京市496例,太原市698例。两地均有较高比例T2D患者存在热量、蛋白质、碳水、脂肪摄入不足或超标,在蛋白质摄入不足(49.2%vs.77.7%)、碳水摄入超标(36.9%vs.56.6%)及脂肪摄入超标(60.7%vs.40.4%)的患者占比,以及蛋白、碳水、脂肪的实际能量占比和建议能量占比方面,两地区差异有统计学意义(P均<0.05)。营养建议调整了三大营养素供能比。从CKD低危、中危到高危/极高危的蛋白质摄入不足患者占比,北京市(51.4%∶42.7%∶51.2%)差异无统计学意义(P>0.05);太原市下降趋势显著(85.2%∶55.4%∶46.5%)(P<0.05),每公斤体质量日蛋白质摄入北京被建议1.01~g的患者占比最高,太原低危和中危患者被建议≥1.31 g的占比最高,高危/极高危患者被建议0.80~g的患者占比最高。结论 北京及太原市T2D患者普遍存在热量摄入及饮食结构不合理,无论是CKD低危、中危还是高危/极高危患者,两城市均有相当比例患者不适当蛋白质摄入过低,需引起关注。不同CKD分层患者获得的蛋白质摄入建议差别显著,或与地区饮食特点及营养实践有关。Objective To analyze the dietary characteristics and nutritional recommendations for type 2 diabetes(T2D)patients in Beijing and Taiyuan at different chronic kidney disease(CKD)risk,and to understand the gap between clinical nutrition practices and guidelines.Methods A retrospective analysis of T2D patients evaluated by professional nutritionists in 2 diabetes hospital in Beijing and Taiyuan from March 2018 to December 2019.A questionnaire survey was used to collect general information.A diet review method was used to assess the patient’s food intake.Results A total of 1 194 patients were enrolled into this analysis,496 from Beijing and 698 from Taiyuan.High proportion of insufficient or excess intake of overall calorice,protein,carbohydrate and fat were found.Significant difference were seen between Beijing and Taiyuan in respect of insufficient intake of protein(49.2% vs.77.7%),excess intake of carbohydrate(36.9% vs.56.6%)and fat(60.7%vs.40.4%),as well as actual(Beijing 14.6∶48.9∶36.5 vs.Taiyuan 11.2∶61.4∶27.4)and recommended energy supply ratio for protein,carbohydrate and fat(P all<0.05).The adjusted energy supply ratios were provided.In the respect of insufficient protein intake in patients at low,moderate or high/very-high CKD risk,no significant difference were found in Beijing(51.4%︰42.7%︰51.2%)but significant downward trend was seen in Taiyuan(85.2%∶55.4%∶46.5%)(P<0.05).The highest proportion of daily protein intake recommendation(per kilogram of body weight)was 1.01~g in Beijing patients,while ≥1.31 g in Taiyuan patients at low or moderate risk and 0.80~g at high/very high risk.Conclusion Enough attention should be paid on the ubiquitously unreasonable calorie intake and diet pattern seen in T2D patients in Beijing and Taiyuan.Regardless low,moderate or high/very high CKD risk,a considerable inappropriately insufficient protein intake was found in the two cities.The protein intake recommendations for patients at different CKD risk are significantly different,which may be related to r

关 键 词：慢性肾脏病 危险分层 糖尿病 饮食特点 营养指导 

分 类 号：R587.1[医药卫生—内分泌]