中国糖尿病杂志
中國糖尿病雜誌
중국당뇨병잡지
CHINESE JOURNAL OF DIABETES
2002年
6期
340-343
,共4页
陆菊明%潘长玉%田慧%李春霖%杨国庆%张效良%李溪雅%成筱鹏%许志秀%蔡爱军%樊爱平%李永昌
陸菊明%潘長玉%田慧%李春霖%楊國慶%張效良%李溪雅%成篠鵬%許誌秀%蔡愛軍%樊愛平%李永昌
륙국명%반장옥%전혜%리춘림%양국경%장효량%리계아%성소붕%허지수%채애군%번애평%리영창
糖耐量低减%2型糖尿病%二甲双胍%食物纤维
糖耐量低減%2型糖尿病%二甲雙胍%食物纖維
당내량저감%2형당뇨병%이갑쌍고%식물섬유
Diet fibre
目的观察二甲双胍和食物纤维预防糖耐量低减(IGT)人群进展为2型糖尿病(DM)的作用.方法以口服75 g葡萄糖耐量试验(OGTT)确诊(WHO标准)的IGT 293例中男216例,女77例.入选者年龄35岁以上,体重指数(BMI)在19 kg/m2以上.随机分为对照组72例,教育组57例,食物纤维组84例,二甲双胍组80例.对照组进行一般的健康教育;教育组进行饮食指导,每半年1次;食物纤维组除健康教育外,每日口服食物纤维12 g;二甲双胍组每日口服二甲双胍0.75 g,分3次餐后口服.对四组参试者每半年作1次OGTT,同时测身高、体重、BMI、12 h尿白蛋白,复查日当天不服干预药物或食物纤维.共观察3年.若2次OGTT或最后1次复查结果为DM,则判断为已发展为DM.结果293例IGT在观察中有23例(7.8%)退出.空腹血糖(FBS)和服糖后1 h血糖(1 h PBS)在对照组、教育组和食物纤维组均较治疗前略有升高,但在二甲双胍治疗组均有下降.四组间FBS比较F=8.118,P＜0.01,四组间1 h PBS比较F＝3.697,P＝0.012.观察期末对照组16例(25.0%)、教育组11例(21.6%)、食物纤维组13例(16.3%)、二甲双胍组7例(9.3%)转化为DM,二甲双胍组在治疗后DM转化率明显低于对照组(x2=6.318,P＜0.05),其余各组间比较差异无显著性意义.单因素分析显示:IGT向DM的转化率与治疗前年龄、体重呈正相关(r=0.46和0.36,P＜0.05),与干预方式呈负相关(r＝-0.157,P=0.01).多元回归分析显示:IGT向DM的转化率与FBS呈显著正相关(r＝0.277,P＝0.003),与治疗方式呈负相关(r=-0.131,P＝0.034).结论二甲双胍在延缓IGT向2型DM发展中是有效的,食物纤维可能有一定的作用.
目的觀察二甲雙胍和食物纖維預防糖耐量低減(IGT)人群進展為2型糖尿病(DM)的作用.方法以口服75 g葡萄糖耐量試驗(OGTT)確診(WHO標準)的IGT 293例中男216例,女77例.入選者年齡35歲以上,體重指數(BMI)在19 kg/m2以上.隨機分為對照組72例,教育組57例,食物纖維組84例,二甲雙胍組80例.對照組進行一般的健康教育;教育組進行飲食指導,每半年1次;食物纖維組除健康教育外,每日口服食物纖維12 g;二甲雙胍組每日口服二甲雙胍0.75 g,分3次餐後口服.對四組參試者每半年作1次OGTT,同時測身高、體重、BMI、12 h尿白蛋白,複查日噹天不服榦預藥物或食物纖維.共觀察3年.若2次OGTT或最後1次複查結果為DM,則判斷為已髮展為DM.結果293例IGT在觀察中有23例(7.8%)退齣.空腹血糖(FBS)和服糖後1 h血糖(1 h PBS)在對照組、教育組和食物纖維組均較治療前略有升高,但在二甲雙胍治療組均有下降.四組間FBS比較F=8.118,P＜0.01,四組間1 h PBS比較F＝3.697,P＝0.012.觀察期末對照組16例(25.0%)、教育組11例(21.6%)、食物纖維組13例(16.3%)、二甲雙胍組7例(9.3%)轉化為DM,二甲雙胍組在治療後DM轉化率明顯低于對照組(x2=6.318,P＜0.05),其餘各組間比較差異無顯著性意義.單因素分析顯示:IGT嚮DM的轉化率與治療前年齡、體重呈正相關(r=0.46和0.36,P＜0.05),與榦預方式呈負相關(r＝-0.157,P=0.01).多元迴歸分析顯示:IGT嚮DM的轉化率與FBS呈顯著正相關(r＝0.277,P＝0.003),與治療方式呈負相關(r=-0.131,P＝0.034).結論二甲雙胍在延緩IGT嚮2型DM髮展中是有效的,食物纖維可能有一定的作用.
목적관찰이갑쌍고화식물섬유예방당내량저감(IGT)인군진전위2형당뇨병(DM)적작용.방법이구복75 g포도당내량시험(OGTT)학진(WHO표준)적IGT 293례중남216례,녀77례.입선자년령35세이상,체중지수(BMI)재19 kg/m2이상.수궤분위대조조72례,교육조57례,식물섬유조84례,이갑쌍고조80례.대조조진행일반적건강교육;교육조진행음식지도,매반년1차;식물섬유조제건강교육외,매일구복식물섬유12 g;이갑쌍고조매일구복이갑쌍고0.75 g,분3차찬후구복.대사조삼시자매반년작1차OGTT,동시측신고、체중、BMI、12 h뇨백단백,복사일당천불복간예약물혹식물섬유.공관찰3년.약2차OGTT혹최후1차복사결과위DM,칙판단위이발전위DM.결과293례IGT재관찰중유23례(7.8%)퇴출.공복혈당(FBS)화복당후1 h혈당(1 h PBS)재대조조、교육조화식물섬유조균교치료전략유승고,단재이갑쌍고치료조균유하강.사조간FBS비교F=8.118,P＜0.01,사조간1 h PBS비교F＝3.697,P＝0.012.관찰기말대조조16례(25.0%)、교육조11례(21.6%)、식물섬유조13례(16.3%)、이갑쌍고조7례(9.3%)전화위DM,이갑쌍고조재치료후DM전화솔명현저우대조조(x2=6.318,P＜0.05),기여각조간비교차이무현저성의의.단인소분석현시:IGT향DM적전화솔여치료전년령、체중정정상관(r=0.46화0.36,P＜0.05),여간예방식정부상관(r＝-0.157,P=0.01).다원회귀분석현시:IGT향DM적전화솔여FBS정현저정상관(r＝0.277,P＝0.003),여치료방식정부상관(r=-0.131,P＝0.034).결론이갑쌍고재연완IGT향2형DM발전중시유효적,식물섬유가능유일정적작용.
Objective To evaluate the efficacy of metformin and diet fibre intervention in preventing the conversion of impaired glucose tolerance (IGT) to type 2 diabetes mellitus.Methods The recruited 293 IGT subjects were diagnosed by 75 g OGTT (WHO, 1985), with their age more than 35 years and BMI more than 19 kg/m 2. They were divided into 4 groups, i.e. control (C) (72 cases), education (E) (57 cases), diet fibre (DF) (84 cases) and metformin (M) (80 cases) groups. The subjects of group E were given healthy diet education. The subjects of group DF were treated with diet fibre 12g daily, and group M were given metformin 0.75 g daily. 75 g OGTT was done every 6 months. They were followed 3 years. The primary end point was the development of diabetes based on 2 hour plasma glucose after 75 g glucose load. Results The IGT subjects consisted of 216 males and 77 females. 23 subjects (7.8%) were discontinued prematurely. At the end of the study, the fasting blood sugar (FBS) and post OGTT 1 hour glucose levels were slightly higher in group C, E, DF than baseline data, while both above glucose levels were significantly lower than baseline in group M( F=8.118, P<0.001, F=3.697, P= 0.012). The cumulative cases with conversion to diabetes were 16 (25.0%) in group C, 11(21.6%) in group E, 13(16.3%) in group DF, and 7( 9.33% ) in group M. Using the Chi square test the conversion rate of diabetes was significantly lower in group M than group C. The diabetes conversion rate was positively related to the age and FBS ( P <0.05) and was negatively related to the intervention methods ( P =0.013) using mono factor statistical analysis. And the diabetes conversion rate was positively related to the FBS( P = 0.03 ), and was negatively to the intervention methods ( P =0.034) using multi regression analysis. Conclusion Metformin is effective in delaying the conversion of IGT to type 2 diabetes mellitus. The diet fibre may also be effective in IGT intervention.
