个性化饮食干预对新疆2型糖尿病患者氧化应激状态影响的研究

发布时间：2018-09-17 16:23

【摘要】：目的:1)了解新疆地区T2DM患者的饮食现状及氧化应激水平;2)评价个性化饮食干预对T2DM患者营养风险发生率、营养素摄入量、氧化应激指标、糖代谢指标、脂代谢指标以及人体测量学指标的影响。方法:选取新疆医科大学第一附属医院内分泌科2016年1月到2016年12月住院治疗的T2DM患者160例,按照随机数字表法将患者分为对照组与实验组,每组各80例。所有参加本研究的T2DM患者除饮食有分组要求以外,其余原有的DM治疗方案和生活方式严格维持原状,时间全程3个月。在此基础上对照组患者给予医院常规饮食健康教育和传统的食物交换份法进行饮食干预;实验组患者给予个性化饮食干预。通过检测两组受试者血清中氧化应激(测定血清丙二醛含量,以评价机体氧化应激;测定血清超氧化物歧化酶、维生素C、维生素E含量,评价机体的抗氧化防御)、糖代谢、脂代谢指标含量,以及人体测量学指标的变化,比较干预前后两组患者各指标的改善及相关性,分析氧化应激水平的差异性。结果:1)基线情况调查结果:两组患者在人口学资料、疾病状态、营养风险筛查评分等方面差异无统计学意义(P0.05);2)干预前后组间比较:干预后实验组患者营养素摄入量(碳水化合物、钙、锌、硒、VC、VE)、氧化应激指标(超氧化物歧化酶、维生素C、维生素E)及高密度脂蛋白胆固醇均有升高;营养风险发生率、能量、脂肪、钠、蛋白质、丙二醛、糖代谢指标、甘油三酯、总胆固醇、低密度脂蛋白胆固醇及人体测量学均降低;与对照组比较,差异具有统计学意义(P0.05);3)两组患者自身前后组内比较:实验组患者干预后与干预前相比较,营养素摄入量(碳水化合物、钙、锌、硒、VC、VE)、氧化应激指标(超氧化物歧化酶、维生素C、维生素E)、高密度脂蛋白胆固醇指标均明显升高;能量、脂肪、钠、蛋白质、丙二醛、糖代谢指标、甘油三酯、总胆固醇、低密度脂蛋白胆固醇及人体测量学等指标均降低,差异均有统计学意义(P0.05)。对照组糖代谢指标与甘油三酯(TG)降低,高密度脂蛋白胆固醇(HDL-C)升高,差异有统计学意义(P0.05);其余各项指标与干预前比较,差异无统计学意义(P0.05);4)干预前后两组差值比较:实验组在控制氧化应激、血糖、血脂、人体测量学指标方面优于对照组(P0.05);5)相关性分析:超氧化物歧化酶与糖代谢指标、体重指数、甘油三酯负相关;与高密度脂蛋白胆固醇呈正相关。丙二醛与糖代谢指标、体重指数、甘油三酯正相关;与高密度脂蛋白胆固醇负相关。维生素E与高密度脂蛋白胆固醇成正相关,与体重指数、肱三头肌皮褶厚度呈负相关。维生素C与肱三头肌皮褶厚度与呈负相关。以上结果均有统计学意义(P0.05);结论:T2DM患者体内氧化应激水平较高,且随着血糖的水平的升高而逐渐升高。个性化饮食干预可改善患者营养素摄入量及体内氧化应激状态,降低血糖水平,调节血脂,减轻或控制营养不良发生的风险,对改善胰岛素β细胞功能及胰岛素抵抗状态有着众多益处。同时可为新疆地区指导T2DM患者合理膳食、促进生命质量提供理论依据。
[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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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