CAJ | 학술논문

目的：评价联合低血糖生成指数（ LGI ）及低血糖生成负荷（ LGL ）的饮食干预对社区2型糖尿病（T2DM）患者血糖血脂代谢指标的影响。方法整群随机抽取湖南省长沙市金盆岭三真社区内三个不同小区，分别在各小区内随机抽取已确诊的T2DM且符合本研究纳入标准的35例患者为研究对象，将三个小区以抽签的形式随机分为全天饮食干预组（A组）、早餐饮食干预组（B组）及对照组（C组）。通过3个月分组干预，即保持患者原治疗方案不变的情况下，指导A组患者一日三餐采用LGI及LGL的食物，B组仅早餐采用LGI及LGL的食物，而C组饮食不作要求，比较干预前后三组患者空腹血糖（FBG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）指标的变化。符合正态分布的计量资料比较采用单因素的方差分析。结果多个独立样本比较Kruskal-Wallis H检验显示，干预前后三组的 HbA1c 均有改善（均 P ＜0.05），其中 A 组 HbA1c 改善优于 B、C 组（H ＝26.749，P ＜0.0167）；干预前后三组的HDL-C均有所下降（均P＜0.05），其中A组患者的HDL-C下降幅度大于B组及C组（H＝12.671，P＜0.0167）；干预前后三组的TG均有改善（均P＜0.05），其中A组、B组的TG改善优于C组（H＝14.921，P＜0.0167）。结论联合LGI及LGL饮食干预能有效改善T2DM患者HbA1c、HDL-C及TG，其中全天饮食干预较早餐饮食干预更有效。
목적：평개연합저혈당생성지수（ LGI ）급저혈당생성부하（ LGL ）적음식간예대사구2형당뇨병（T2DM）환자혈당혈지대사지표적영향。방법정군수궤추취호남성장사시금분령삼진사구내삼개불동소구，분별재각소구내수궤추취이학진적T2DM차부합본연구납입표준적35례환자위연구대상，장삼개소구이추첨적형식수궤분위전천음식간예조（A조）、조찬음식간예조（B조）급대조조（C조）。통과3개월분조간예，즉보지환자원치료방안불변적정황하，지도A조환자일일삼찬채용LGI급LGL적식물，B조부조찬채용LGI급LGL적식물，이C조음식불작요구，비교간예전후삼조환자공복혈당（FBG）、찬후2 h혈당（2 hPG）、당화혈홍단백（HbA1c）、감유삼지（TG）、총담고순（TC）、고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL-C）지표적변화。부합정태분포적계량자료비교채용단인소적방차분석。결과다개독립양본비교Kruskal-Wallis H검험현시，간예전후삼조적 HbA1c 균유개선（균 P ＜0.05），기중 A 조 HbA1c 개선우우 B、C 조（H ＝26.749，P ＜0.0167）；간예전후삼조적HDL-C균유소하강（균P＜0.05），기중A조환자적HDL-C하강폭도대우B조급C조（H＝12.671，P＜0.0167）；간예전후삼조적TG균유개선（균P＜0.05），기중A조、B조적TG개선우우C조（H＝14.921，P＜0.0167）。결론연합LGI급LGL음식간예능유효개선T2DM환자HbA1c、HDL-C급TG，기중전천음식간예교조찬음식간예경유효。
Objective To evaluate the effects of combined low glycemic index ( LGI ) and low glycemic load ( LGL) diet intervention on glucose and lipid metabolism in community patients with type 2 diabetes mellitus ( T2DM).Methods A total of 105 patients with T2DM were enrolled from 3 different communities in Changsha city in this study , 35 T2DM patients in each community with met inclusion criteria.The three communities were randomly divided into the whole day diet intervention group ( group A), breakfast intervention group (B group) and control group (group C) by draw lots.The patients with T2DM in group A and group B received 3 months combined LGI and LGL diet intervention at the basis of keeping the original regimen.All the subjects in the study were tested fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol ( TC ) , high density lipoprotein-cholesterol ( HDL-C ) and low density lipoprotein-cholesterol ( LDL-C ) before and after dietary intervention.The quantitative data obeying normal distribution were compared with one-way analysis of variance.Results Multiple independent sample Kruskal-Wallis H test showed that the HbA1c of three groups improved after the intervention (all P<0.05), and it was better in group A than that in group B and C (H=26.749, P<0.0167).The HDL-C in the three groups decreased significantly after the intervention ( all P<0.05) , and it decreased further in group A than that in group B and C (H =12.671,P <0.0167).The metabolism of TG in patients with T2DM of the three groups improved significantly when compared with those before intervention ( all P <0.01 ) , and it was better in group A and B than that in group C (H=14.921, P<0.05).Conclusion Combined LGI and LGL diet intervention can effectively improve HbA 1c, HDL-C and TG of the patients with T2DM, especially the whole day diet intervention is more effective than only breakfast diet intervention.