糖尿病前期人群运动、营养干预后一年随访形态与糖、脂、骨代谢变化研究

发布时间：2018-04-30 20:33

本文选题：糖尿病前期 + 随访　；参考：《上海体育学院》2017年硕士论文

【摘要】：研究目的:糖调节受损是普通人向糖尿病转变的过渡阶段和必经阶段,具有可逆性,在该阶段采取生活方式干预,能很大程度上减缓甚至逆转糖尿病前期向2型糖尿病转换的过程。但生活方式干预停止后,干预产生的对血糖、血脂的控制作用和生活方式如何变化,目前较不明确。本研究在对受试者前期进行生活方式干预后,停止对受试者的生活方式干预,一年后随访,观察其血糖、血脂、身体形态、生活方式等方面的变化,以期为2型糖尿病前期患者的健康促进方案和预防措施提供科学的理论依据,保证整体实验的完整性。研究方法:本研究前期招募糖尿病前期的22名50-65岁绝经后中老年妇女进行为期6个月生活方式干预,随机分为对照组、运动干预组和饮食干预组。运动干预的方式为北欧式行走(Nordic Walking),运动频率为每周2~3次,每次50~60分钟,运动强度为65%~85%的最大心率。饮食干预主要采取以低碳水化合物为主的午餐饮食干预。6个月的生活方式干预后,对受试者进行为期一年的随访,随访期间不对受试者的生活方式采取任何干预措施,为保证实验完整性,减少受试者的流失,采取不定期与受试者通话、上门沟通、定期组织活动、微信建群等方式维护与受试者的良好关系。随访测试中集合受试者,于晚上8点后禁食,第二天早上7点进行OGTT测试,获取血液指标,血液检验由上海市市东医院完成。身体成分和骨密度数据受试者在上海体育学院运动健身科学馆Dax身体成分骨密度仪进行测定。分别将对照组、运动组和饮食组0M、6M和18M的测试数据进行对比,同一组不同时间段的数据分析采用配对T检验的分析方法,同一时间点不同组别的数据采取方差检验,p0.05表示在统计学上具有显著性差异。研究结果:(1)一年后随访中对照组和饮食组胆固醇较6M干预后下降,运动组略有上升;三组的甘油三酯较干预后都有下降,三组相比运动组和饮食组均低于对照组且均p0.05;高密度脂蛋白对照组随访较0M明显下降,p0.05,干预组均高于对照组;低密度脂蛋白随访干预组均低于对照组。(2)一年后随访时干预组的FBG水平均低于对照组,运动组在3组中最低;餐后2h血糖较0M和6M都有所增加,但对照组最高;糖化血红蛋白饮食组0M与18M相比明显下降,p0.05,三组随访时相比对照组最高,饮食组最低。(3)一年后随访上肢脂肪占比都呈下降趋势,运动组和饮食组0M和18M相比明显下降且均,P0.05;下肢脂肪比三组随访时出现下降,饮食组0M和18M相比明显下降,p0.05;躯干脂肪占比3组同样呈下降趋势,运动组和饮食组0M和18M相比均出现明显下降且均p0.05;腰区(腰区)脂肪比3组在干预后和随访时的差异不大;臀区(臀区)脂肪比运动组和饮食组0M和18M相比均出现明显下降且均p0.05;全身脂肪占比3组均呈下降趋势,运动组0M和6M、0M和18M相比均明显下降且p0.05,饮食组0M和18M出现下降且p0.05。(4)一年后随访对照组的上肢、下肢、躯干、腰区、臀区及全身肌肉质量与0M和6M相比均出现明显下降。运动组和饮食组上肢和下肢的肌肉质量较0M和6M出现下降,降幅明显小于对照组。干预组18M躯干、腰区、臀区及全身肌肉质量均出现增加。(5)一年后随访骨密度3组均出现下降,对照组最低;运动组6M与18M相比出现下降且p0.05;饮食组0M与18M相比,P0.05,6M与18M相比,P0.05。(6)一年后随访运动组18M与6M相比运动频率和运动时间略有下降但高于对照组。运动组有一部分受试者仍会采取北欧式行走的运动方式。饮食组18M与6M相比蛋白质的摄入减少,脂肪和碳水化合物摄入有所增加。饮食组在饮食过程中仍注重粗粮和膳食纤维的摄入。研究结论:(1)运动或饮食干预后,干预对血糖、血脂的控制作用仍存在但出现下降趋势,要继续保持健康的生活方式;(2)运动或饮食干预停止后,干预对减少肌肉流失的有利影响仍在存在,脂肪含量有所增加,要持续保持干预时的运动或饮食方式才能有持续的有利影响;(3)运动和饮食干预对骨密度维持具有持续性积极作用,但其作用随时间的增加而减少;(4)运动、饮食干预对受试者的日常生活方式产生影响,受试者有改善日常生活习惯,注意增加运动和控制饮食。
[Abstract]:Objective: the impaired glucose regulation is the transition stage and the required stage of the ordinary people to diabetes. It is reversible. The intervention of life style at this stage can greatly reduce and even reverse the process of the transition from pre diabetes to type 2 diabetes. However, after the intervention of lifestyle intervention, the control of blood glucose and blood lipids is produced by intervention. It is not clear at present how to change the way of life and life. In this study, the lifestyle intervention of the subjects was stopped, the lifestyle intervention of the subjects was stopped. After one year, the changes of blood sugar, blood lipid, body shape and life style were observed, in order to promote the health promotion plan and prevention measures of patients with pre type 2 diabetes. Scientific theoretical basis was provided to ensure the integrity of the whole experiment. Methods: 22 50-65 year old postmenopausal women with Premenopause were recruited in this study for 6 months of life style intervention, which were randomly divided into control group, exercise intervention group and diet intervention group. The way of exercise intervention was Nordic Walking (North European walk). The exercise frequency is 2~3 times a week, 50~60 minutes each time, and the maximum heart rate of the exercise intensity is 65%~85%. The diet intervention mainly adopts a low carbohydrate based lunch diet intervention for.6 months of life style, and the subjects are followed up for one year, and no intervention measures are taken during the follow-up period. In order to ensure the integrity of the experiment, reduce the loss of the subjects, take the aperiodic conversation with the subjects, communicate with the subjects, organize the activities regularly, and maintain a good relationship with the subjects, such as WeChat construction group. During the follow-up test, the subjects were fasted after 8 p.m., and the OGTT test was carried out at 7 a.m. on the second day. The blood indexes were obtained and the blood test was on the upper part. The body composition and bone mineral density data were measured by the Dax body composition bone densitometer at the sports fitness Science Museum of Shanghai Institute of Physical Education. The test data of the control group, the exercise group and the diet group 0M, 6M and 18M were compared, and the data analysis of the same group of different time periods was analyzed by the paired T test. The data of different groups at the same time were tested by variance, and P0.05 showed significant difference in statistics. (1) the results of the study were as follows: (1) the cholesterol in the control group and the diet group decreased after one year and the exercise group increased slightly, and the triglyceride in the three groups decreased compared with the dry prognosis, and the three groups were lower than the exercise group and the diet group. The control group was all P0.05, the high density lipoprotein control group was significantly lower than the 0M, P0.05, the intervention group were all higher than the control group, and the low density lipoprotein follow-up group was lower than the control group. (2) the level of FBG in the intervention group was lower than the control group one year later, and the exercise group was the lowest in the 3 groups; the 2H blood glucose in the postprandial group was higher than that of the 0M and 6M, but the control group was more than the control group. The glycated hemoglobin diet group 0M was significantly lower than the 18M, P0.05, the three groups were the highest in the control group, and the diet group was the lowest. (3) a year later, the fat occupation of the upper limbs decreased, the exercise group and the diet group were significantly lower than the 0M and 18M and all, P0.05; the lower limb fat was decreased in the three groups, and the diet group 0M and 18M phase Compared to the 3 groups, the body fat accounted for a decrease in the 3 groups. The 0M and 18M in the exercise group and the diet group were both significantly decreased and P0.05, and the fat in the lumbar region (lumbar region) was not significant in the 3 groups. The fat of the hip region (hip region) was significantly lower than that of the exercise group and the diet group 0M and 18M and all P0.05; the whole body was all P0.05; 0M and 6M, 0M and 18M decreased significantly in the exercise group and P0.05, P0.05, 0M and 18M in the diet group and p0.05. (4) in the upper limbs of the control group. The lower limbs, the trunk, the waist area, the hip area and the whole body muscle mass were obviously decreased compared with 0M and 6M. The muscles of the upper limbs and the lower limbs of the exercise group and the diet group were significantly decreased. The volume of 0M and 6M decreased significantly less than the control group. The quality of 18M trunk, lumbar region, hip area and whole body muscle increased in the intervention group. (5) after one year, the follow-up bone density 3 groups decreased, the control group was the lowest; the exercise group 6M and 18M decreased and P0.05; P0.05,6M compared with 18M in the diet group, P0.05,6M and 18M, P0.05. (6) followed up a year later. The exercise group 18M has a slight decrease in movement frequency and time compared with that of the control group but higher than the control group. Some subjects in the exercise group still take the way of the Nordic walking. The dietary group 18M and 6M have less protein intake and more fat and carbohydrate intake. In the diet group, the diet group still pays attention to coarse grain and dietary fiber during the diet process. Conclusions: (1) the control effect of intervention on blood sugar and blood lipids still exists but has a declining tendency to continue to maintain a healthy lifestyle; (2) after the stop of exercise or diet intervention, the beneficial effects of intervention on reducing muscle loss are still existing, the fat content is increased, and the intervention should be maintained. Exercise or diet can have a sustained beneficial effect; (3) exercise and dietary intervention have a sustained and positive effect on bone density maintenance, but their effects decrease with time; (4) exercise, diet intervention has an effect on the routine lifestyle of the subjects, and the subjects can improve their daily habits, pay more attention to exercise and control. Diet.

【学位授予单位】：上海体育学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

【参考文献】