CAJ | 학술논문

目的探讨短期极低热量限食对2型糖尿病患者胰岛素分泌、胰岛素敏感性以及糖脂代谢的影响.方法选取20例2型糖尿病患者,平均年龄(41.3±7.3)岁,体重指数(25.91 ±2.83) kg/m2,其中,男性5例,女性15例,评估胰岛β细胞功能后,实施9天极低热量(300～ 600 kcal/d)限食,重新评估胰岛β细胞功能,对比限食前后受试者血糖、血脂、血压、胰岛素分泌及胰岛素敏感性的变化.结果 (1)限食后患者平均体重由(70.5±1 1.0) kg降至(65.9±10.5) kg(P＜0.01),腰围由(86.68±10.26) cm减至(81.03±9.77) cm(P＜0.001),体重指数由(25.99±2.78) kg/m2降至(23.89±2.66) kg/m2(P＜0.01).其中,内脏脂肪面积由(104.79±29.65) cm2减至(97.44±29.14) cm2(P=0.015),体脂肪重量由(22.8±4.9)kg减至(20.9±4.5)kg(P＜0.01) (2)限食后患者空腹血糖由(8.47±1.77) mmol/L降至(6.30±1.82)mmol/L(P＜0.01),空腹胰岛素由(10.8±4.0) mIU/L降至(7.1±4.2)mIU/L(P＜0.01),甘油三酯由(2.36±1.71) mmol/L降至(1.28±0.50) mmol/L(P＜0.05),收缩压由(127± 11) mmHg(1 mmHg=0.133 kPa)降至(117±10) mmHg(P＜0.01),舒张压由(80±7) mmHg降至(73±10) mmHg(P＜0.01),而总胆固醇、低密度脂蛋白差异无统计学意义.(3)限食后患者静脉葡萄糖耐量试验第一时相胰岛素分泌量由(62.37±40.28)mIU/L增至(98.18±77.17) mIU/L(P＜0.05),口服葡萄糖耐量试验胰岛素分泌曲线下面积变化无统计学意义,限食后患者胰岛素抵抗指数(HOM A-IR)由4.12±1.87降至2.02± 1.25(P＜0.01).结论短期极低热量限食可减轻2型糖尿病患者体重,改善胰岛素抵抗,增加胰岛素一相分泌,改善糖脂代谢,降低血压.
목적 탐토단기겁저열량한식대2형당뇨병환자이도소분비、이도소민감성이급당지대사적영향.방법 선취20례2형당뇨병환자,평균년령(41.3±7.3)세,체중지수(25.91 ±2.83) kg/m2,기중,남성5례,녀성15례,평고이도β세포공능후,실시9천겁저열량(300～ 600 kcal/d)한식,중신평고이도β세포공능,대비한식전후수시자혈당、혈지、혈압、이도소분비급이도소민감성적변화.결과 (1)한식후환자평균체중유(70.5±1 1.0) kg강지(65.9±10.5) kg(P＜0.01),요위유(86.68±10.26) cm감지(81.03±9.77) cm(P＜0.001),체중지수유(25.99±2.78) kg/m2강지(23.89±2.66) kg/m2(P＜0.01).기중,내장지방면적유(104.79±29.65) cm2감지(97.44±29.14) cm2(P=0.015),체지방중량유(22.8±4.9)kg감지(20.9±4.5)kg(P＜0.01) (2)한식후환자공복혈당유(8.47±1.77) mmol/L강지(6.30±1.82)mmol/L(P＜0.01),공복이도소유(10.8±4.0) mIU/L강지(7.1±4.2)mIU/L(P＜0.01),감유삼지유(2.36±1.71) mmol/L강지(1.28±0.50) mmol/L(P＜0.05),수축압유(127± 11) mmHg(1 mmHg=0.133 kPa)강지(117±10) mmHg(P＜0.01),서장압유(80±7) mmHg강지(73±10) mmHg(P＜0.01),이총담고순、저밀도지단백차이무통계학의의.(3)한식후환자정맥포도당내량시험제일시상이도소분비량유(62.37±40.28)mIU/L증지(98.18±77.17) mIU/L(P＜0.05),구복포도당내량시험이도소분비곡선하면적변화무통계학의의,한식후환자이도소저항지수(HOM A-IR)유4.12±1.87강지2.02± 1.25(P＜0.01).결론 단기겁저열량한식가감경2형당뇨병환자체중,개선이도소저항,증가이도소일상분비,개선당지대사,강저혈압.
Objective To study the effects of short-term caloric restriction (CR) on insulin secretion and glucose and lipid metabolism in type 2 diabetic patients.Methods Oral glucose tolerance test,insulin releasing test,and other biochemical tests were performed in 20 type 2 diabetic patients whose body mass index(BMI) was less than 40 kg/m2before and after 9 days with CR(300-600 kcal/d).Results (1) After short-term CR,the patients' mean body weight was reduced from (70.5 ± 11.0) kg to (65.9 ± 10.5) kg(P＜0.01),and their waist circumference from (86.68 ± 10.26) cm to (81.03 ± 9.77) cm (P＜0.001).Moreover,BM1 was reduced from (25.99 ± 2.78) kg/m2 to (23.89 ± 2.66) kg/m2 (P＜0.01),the visceral fat mass area decreased from (104.79 ± 29.65) cm2 to (97.44 ± 29.14) cm2 (P =0.015),and the weight of body fat mass was reduced from (22.8 ± 4.9) kg to (20.9 ± 4.5) kg(P＜ 0.01).(2) After 9 days of CR,there were significant reductions in fasting blood glucose [from (8.47 ± 1.77) mmol/L to (6.30± 1.82) mmol/L,P＜0.01],fasting insulin [from (10.8±4.0) mIU/L to (7.1 ±4.2) mIU/L,P＜ 0.01),and blood triglyceride [from (2.36 ± 1.71) mmol/L to (1.28 ± 0.50) mmol/L,P＜0.05),as well as lowering of systolic blood pressure[from (127 ± 11) mmHg(1 mmHg=0.133 kPa) to (117 ± 10) mmHg,P＜0.01),and diastolic blood pressure [from (80 ± 7) mmHg to (73 ± 10) mmHg,P＜0.01],though,no significant difference was found in total eholesterol and low density lipoprotein levels before and after CR.(3) The first-phase insulin response,which was represented by acute insulin response,was increased from (62.37 ± 40.28) mIU/L to (98.1 8 ± 77.17) mIU/L(P＜0.05) during the study period,while changes in insulin area under the curve showed no significant differences before and after CR.HOMA-IR,which was a parameter of insulin resistance,was decreased from 4.12 ± 1.87 to 2.02 ± 1.25 (P＜0.01).Conclusion Short-term CR can effectively improve islet β cell function,glucose and lipid metabolism in patients with type 2 diabetes.