個性化飲食干預對新疆2型糖尿病患者氧化應激狀態(tài)影響的研究
發(fā)布時間：2018-09-17 16:23
【摘要】：目的:1)了解新疆地區(qū)T2DM患者的飲食現(xiàn)狀及氧化應激水平;2)評價個性化飲食干預對T2DM患者營養(yǎng)風險發(fā)生率、營養(yǎng)素攝入量、氧化應激指標、糖代謝指標、脂代謝指標以及人體測量學指標的影響。方法:選取新疆醫(yī)科大學第一附屬醫(yī)院內(nèi)分泌科2016年1月到2016年12月住院治療的T2DM患者160例,按照隨機數(shù)字表法將患者分為對照組與實驗組,每組各80例。所有參加本研究的T2DM患者除飲食有分組要求以外,其余原有的DM治療方案和生活方式嚴格維持原狀,時間全程3個月。在此基礎上對照組患者給予醫(yī)院常規(guī)飲食健康教育和傳統(tǒng)的食物交換份法進行飲食干預;實驗組患者給予個性化飲食干預。通過檢測兩組受試者血清中氧化應激(測定血清丙二醛含量,以評價機體氧化應激;測定血清超氧化物歧化酶、維生素C、維生素E含量,評價機體的抗氧化防御)、糖代謝、脂代謝指標含量,以及人體測量學指標的變化,比較干預前后兩組患者各指標的改善及相關性,分析氧化應激水平的差異性。結果:1)基線情況調(diào)查結果:兩組患者在人口學資料、疾病狀態(tài)、營養(yǎng)風險篩查評分等方面差異無統(tǒng)計學意義(P0.05);2)干預前后組間比較:干預后實驗組患者營養(yǎng)素攝入量(碳水化合物、鈣、鋅、硒、VC、VE)、氧化應激指標(超氧化物歧化酶、維生素C、維生素E)及高密度脂蛋白膽固醇均有升高;營養(yǎng)風險發(fā)生率、能量、脂肪、鈉、蛋白質(zhì)、丙二醛、糖代謝指標、甘油三酯、總膽固醇、低密度脂蛋白膽固醇及人體測量學均降低;與對照組比較,差異具有統(tǒng)計學意義(P0.05);3)兩組患者自身前后組內(nèi)比較:實驗組患者干預后與干預前相比較,營養(yǎng)素攝入量(碳水化合物、鈣、鋅、硒、VC、VE)、氧化應激指標(超氧化物歧化酶、維生素C、維生素E)、高密度脂蛋白膽固醇指標均明顯升高;能量、脂肪、鈉、蛋白質(zhì)、丙二醛、糖代謝指標、甘油三酯、總膽固醇、低密度脂蛋白膽固醇及人體測量學等指標均降低,差異均有統(tǒng)計學意義(P0.05)。對照組糖代謝指標與甘油三酯(TG)降低,高密度脂蛋白膽固醇(HDL-C)升高,差異有統(tǒng)計學意義(P0.05);其余各項指標與干預前比較,差異無統(tǒng)計學意義(P0.05);4)干預前后兩組差值比較:實驗組在控制氧化應激、血糖、血脂、人體測量學指標方面優(yōu)于對照組(P0.05);5)相關性分析:超氧化物歧化酶與糖代謝指標、體重指數(shù)、甘油三酯負相關;與高密度脂蛋白膽固醇呈正相關。丙二醛與糖代謝指標、體重指數(shù)、甘油三酯正相關;與高密度脂蛋白膽固醇負相關。維生素E與高密度脂蛋白膽固醇成正相關,與體重指數(shù)、肱三頭肌皮褶厚度呈負相關。維生素C與肱三頭肌皮褶厚度與呈負相關。以上結果均有統(tǒng)計學意義(P0.05);結論:T2DM患者體內(nèi)氧化應激水平較高,且隨著血糖的水平的升高而逐漸升高。個性化飲食干預可改善患者營養(yǎng)素攝入量及體內(nèi)氧化應激狀態(tài),降低血糖水平,調(diào)節(jié)血脂,減輕或控制營養(yǎng)不良發(fā)生的風險,對改善胰島素β細胞功能及胰島素抵抗狀態(tài)有著眾多益處。同時可為新疆地區(qū)指導T2DM患者合理膳食、促進生命質(zhì)量提供理論依據(jù)。
[Abstract]:Objective: 1) To understand the dietary status and oxidative stress level of T2DM patients in Xinjiang; 2) To evaluate the effects of individualized dietary intervention on nutritional risk, nutrient intake, oxidative stress index, glucose metabolism index, lipid metabolism index and anthropometric index of T2DM patients. From January 2016 to December 2016, 160 inpatients with T2DM were divided into control group and experimental group according to the method of random number table, each group had 80 cases. The control group was given health education of routine diet and diet intervention of traditional food exchange method, and the experimental group was given individualized diet intervention. Vitamin E content, evaluation of the body's anti-oxidative defense, glucose metabolism, lipid metabolism, and anthropometric indicators of changes, before and after the intervention to compare the improvement of indicators and correlation between the two groups of patients, analysis of differences in oxidative stress levels. Results: 1) Baseline survey results: two groups of patients in demographic data, disease status, camp. There was no significant difference in nutritional risk screening score (P 0.05); 2) Comparison between groups before and after intervention: Nutrient intake (carbohydrate, calcium, zinc, selenium, VC, VE), oxidative stress index (superoxide dismutase, vitamin C, vitamin E) and high-density lipoprotein cholesterol (HDL-C) were increased in the experimental group after intervention; Amount, fat, sodium, protein, malondialdehyde, glucose metabolism indicators, triglyceride, total cholesterol, low-density lipoprotein cholesterol and anthropometry were reduced; compared with the control group, the difference was statistically significant (P Compounds, calcium, zinc, selenium, VC, VE, oxidative stress indicators (superoxide dismutase, vitamin C, vitamin E), high-density lipoprotein cholesterol indicators were significantly increased; energy, fat, sodium, protein, malondialdehyde, glucose metabolism indicators, triglycerides, total cholesterol, low-density lipoprotein cholesterol and anthropometric indicators were reduced, the differences were unified. There was a significant difference between the control group and the control group (P 0.05). Glucose metabolism index and triglyceride (TG) decreased, high-density lipoprotein cholesterol (HDL-C) increased, the difference was statistically significant (P 0.05); the other indicators compared with the pre-intervention, there was no significant difference (P 0.05); 4) The difference between the two groups before and after intervention: experimental group in the control of oxidative stress, blood sugar, blood lipids, body measurement. Quantitative indicators were better than the control group (P 0.05); 5) Correlation analysis: superoxide dismutase and glucose metabolism indicators, body mass index, triglyceride negatively correlated; and high-density lipoprotein cholesterol was positively correlated. Malondialdehyde and glucose metabolism indicators, body mass index, triglyceride positively correlated; and high-density lipoprotein cholesterol negatively correlated. Vitamin C was negatively correlated with the thickness of triceps brachii skin fold. The above results were statistically significant (P 0.05); Conclusion: The oxidative stress level in T2DM patients was higher, and gradually increased with the increase of blood sugar level. It can improve the intake of nutrients and oxidative stress, reduce blood sugar, regulate blood lipids, reduce or control the risk of malnutrition, and has many benefits to improve insulin beta cell function and insulin resistance. It can also provide theoretical basis for guiding the rational diet of T2DM patients in Xinjiang and promoting the quality of life. According to it.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.5
本文編號：2246471
[Abstract]:Objective: 1) To understand the dietary status and oxidative stress level of T2DM patients in Xinjiang; 2) To evaluate the effects of individualized dietary intervention on nutritional risk, nutrient intake, oxidative stress index, glucose metabolism index, lipid metabolism index and anthropometric index of T2DM patients. From January 2016 to December 2016, 160 inpatients with T2DM were divided into control group and experimental group according to the method of random number table, each group had 80 cases. The control group was given health education of routine diet and diet intervention of traditional food exchange method, and the experimental group was given individualized diet intervention. Vitamin E content, evaluation of the body's anti-oxidative defense, glucose metabolism, lipid metabolism, and anthropometric indicators of changes, before and after the intervention to compare the improvement of indicators and correlation between the two groups of patients, analysis of differences in oxidative stress levels. Results: 1) Baseline survey results: two groups of patients in demographic data, disease status, camp. There was no significant difference in nutritional risk screening score (P 0.05); 2) Comparison between groups before and after intervention: Nutrient intake (carbohydrate, calcium, zinc, selenium, VC, VE), oxidative stress index (superoxide dismutase, vitamin C, vitamin E) and high-density lipoprotein cholesterol (HDL-C) were increased in the experimental group after intervention; Amount, fat, sodium, protein, malondialdehyde, glucose metabolism indicators, triglyceride, total cholesterol, low-density lipoprotein cholesterol and anthropometry were reduced; compared with the control group, the difference was statistically significant (P Compounds, calcium, zinc, selenium, VC, VE, oxidative stress indicators (superoxide dismutase, vitamin C, vitamin E), high-density lipoprotein cholesterol indicators were significantly increased; energy, fat, sodium, protein, malondialdehyde, glucose metabolism indicators, triglycerides, total cholesterol, low-density lipoprotein cholesterol and anthropometric indicators were reduced, the differences were unified. There was a significant difference between the control group and the control group (P 0.05). Glucose metabolism index and triglyceride (TG) decreased, high-density lipoprotein cholesterol (HDL-C) increased, the difference was statistically significant (P 0.05); the other indicators compared with the pre-intervention, there was no significant difference (P 0.05); 4) The difference between the two groups before and after intervention: experimental group in the control of oxidative stress, blood sugar, blood lipids, body measurement. Quantitative indicators were better than the control group (P 0.05); 5) Correlation analysis: superoxide dismutase and glucose metabolism indicators, body mass index, triglyceride negatively correlated; and high-density lipoprotein cholesterol was positively correlated. Malondialdehyde and glucose metabolism indicators, body mass index, triglyceride positively correlated; and high-density lipoprotein cholesterol negatively correlated. Vitamin C was negatively correlated with the thickness of triceps brachii skin fold. The above results were statistically significant (P 0.05); Conclusion: The oxidative stress level in T2DM patients was higher, and gradually increased with the increase of blood sugar level. It can improve the intake of nutrients and oxidative stress, reduce blood sugar, regulate blood lipids, reduce or control the risk of malnutrition, and has many benefits to improve insulin beta cell function and insulin resistance. It can also provide theoretical basis for guiding the rational diet of T2DM patients in Xinjiang and promoting the quality of life. According to it.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.5
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