中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
Chinese Journal of Clinical Nutrition
2015年
5期
271-277
,共7页
汪明芳%王丽娟%任姗姗%程博%丁丽丽%陈燕波%王璐%杨子艳%李长平
汪明芳%王麗娟%任姍姍%程博%丁麗麗%陳燕波%王璐%楊子豔%李長平
왕명방%왕려연%임산산%정박%정려려%진연파%왕로%양자염%리장평
糖尿病%超重%营养状态%少肌症
糖尿病%超重%營養狀態%少肌癥
당뇨병%초중%영양상태%소기증
Diabetes%Overweight%Nutritional state%Sarcopenia
目的 了解糖尿病患者的营养状况及其少肌症的影响因素.方法 对2013年1月至2014年12月北京医院营养科门诊297例糖尿病患者进行回顾性分析,比较非超重组[体质量指数(BMI)≤23.9 kg/m2]与超重组(BMI≥24.0 kg/m2)人体测量指标、身体成分、实验室检查指标、膳食摄入的差别,并分析糖尿病患者少肌症发生的影响因素.结果 超重组183例、非超重组114例,非超重组左手握力、右手握力、腰臀比及臂肌围均低于超重组[(24.14±7.76) kg比(27.78±9.31) kg, P=0.00;(25.55±7.86) kg比(28.62±9.55) kg, P=0.01;0.85±0.06比0.92±0.07,P=0.00;(21.45±3.73) cm比(25.18±4.36) cm,P=0.00];非超重组的肌肉量、体脂百分比、内脏脂肪面积及骨骼肌指数均低于超重组[(37.64±6.58) kg比(45.66±8.92) kg;(27.25±8.15)％比(35.52±6.56)％;(71.56±25.28) cm2比(118.84 ±28.18) cm2;(6.22±1.17) kg/m2比(7.41±1.25) kg/m2](P均=0.00);非超重组血红蛋白水平低于超重组[(136.29±14.81) g/L比(141.01±13.47) g/L,P=0.03];两组总蛋白及白蛋白水平差异无统计学意义(P =0.15,P=0.52);非超重组血糖水平低于超重组[(7.08±2.28) mmol/L比(7.76±2.57)mmol/L,P=0.03];非超重组与超重组的能量及蛋白质摄入差异无统计学意义(P =0.17,P=0.35).糖尿病患者少肌症的检出率为10.4％ (31/297),非超重患者的少肌症检出率高于超重患者(22.8％比2.7％,P=0.00).回归分析结果显示,女性(B=-1.371,95％ CI=-1.595～-1.146)、增龄(B=-0.018,95％ CI=-0.027～-0.009)、低BMI(B=-0.115,95％ CI=0.092～0.138)、能量摄入的减少(B =0.014,95％ CI=0.000～-0.029)是骨骼肌指数降低的主要危险因素.结论 糖尿病患者BMI在适度超重的范围内有更好的营养状态,有利于预防少肌症的发生.
目的 瞭解糖尿病患者的營養狀況及其少肌癥的影響因素.方法 對2013年1月至2014年12月北京醫院營養科門診297例糖尿病患者進行迴顧性分析,比較非超重組[體質量指數(BMI)≤23.9 kg/m2]與超重組(BMI≥24.0 kg/m2)人體測量指標、身體成分、實驗室檢查指標、膳食攝入的差彆,併分析糖尿病患者少肌癥髮生的影響因素.結果 超重組183例、非超重組114例,非超重組左手握力、右手握力、腰臀比及臂肌圍均低于超重組[(24.14±7.76) kg比(27.78±9.31) kg, P=0.00;(25.55±7.86) kg比(28.62±9.55) kg, P=0.01;0.85±0.06比0.92±0.07,P=0.00;(21.45±3.73) cm比(25.18±4.36) cm,P=0.00];非超重組的肌肉量、體脂百分比、內髒脂肪麵積及骨骼肌指數均低于超重組[(37.64±6.58) kg比(45.66±8.92) kg;(27.25±8.15)％比(35.52±6.56)％;(71.56±25.28) cm2比(118.84 ±28.18) cm2;(6.22±1.17) kg/m2比(7.41±1.25) kg/m2](P均=0.00);非超重組血紅蛋白水平低于超重組[(136.29±14.81) g/L比(141.01±13.47) g/L,P=0.03];兩組總蛋白及白蛋白水平差異無統計學意義(P =0.15,P=0.52);非超重組血糖水平低于超重組[(7.08±2.28) mmol/L比(7.76±2.57)mmol/L,P=0.03];非超重組與超重組的能量及蛋白質攝入差異無統計學意義(P =0.17,P=0.35).糖尿病患者少肌癥的檢齣率為10.4％ (31/297),非超重患者的少肌癥檢齣率高于超重患者(22.8％比2.7％,P=0.00).迴歸分析結果顯示,女性(B=-1.371,95％ CI=-1.595～-1.146)、增齡(B=-0.018,95％ CI=-0.027～-0.009)、低BMI(B=-0.115,95％ CI=0.092～0.138)、能量攝入的減少(B =0.014,95％ CI=0.000～-0.029)是骨骼肌指數降低的主要危險因素.結論 糖尿病患者BMI在適度超重的範圍內有更好的營養狀態,有利于預防少肌癥的髮生.
목적 료해당뇨병환자적영양상황급기소기증적영향인소.방법 대2013년1월지2014년12월북경의원영양과문진297례당뇨병환자진행회고성분석,비교비초중조[체질량지수(BMI)≤23.9 kg/m2]여초중조(BMI≥24.0 kg/m2)인체측량지표、신체성분、실험실검사지표、선식섭입적차별,병분석당뇨병환자소기증발생적영향인소.결과 초중조183례、비초중조114례,비초중조좌수악력、우수악력、요둔비급비기위균저우초중조[(24.14±7.76) kg비(27.78±9.31) kg, P=0.00;(25.55±7.86) kg비(28.62±9.55) kg, P=0.01;0.85±0.06비0.92±0.07,P=0.00;(21.45±3.73) cm비(25.18±4.36) cm,P=0.00];비초중조적기육량、체지백분비、내장지방면적급골격기지수균저우초중조[(37.64±6.58) kg비(45.66±8.92) kg;(27.25±8.15)％비(35.52±6.56)％;(71.56±25.28) cm2비(118.84 ±28.18) cm2;(6.22±1.17) kg/m2비(7.41±1.25) kg/m2](P균=0.00);비초중조혈홍단백수평저우초중조[(136.29±14.81) g/L비(141.01±13.47) g/L,P=0.03];량조총단백급백단백수평차이무통계학의의(P =0.15,P=0.52);비초중조혈당수평저우초중조[(7.08±2.28) mmol/L비(7.76±2.57)mmol/L,P=0.03];비초중조여초중조적능량급단백질섭입차이무통계학의의(P =0.17,P=0.35).당뇨병환자소기증적검출솔위10.4％ (31/297),비초중환자적소기증검출솔고우초중환자(22.8％비2.7％,P=0.00).회귀분석결과현시,녀성(B=-1.371,95％ CI=-1.595～-1.146)、증령(B=-0.018,95％ CI=-0.027～-0.009)、저BMI(B=-0.115,95％ CI=0.092～0.138)、능량섭입적감소(B =0.014,95％ CI=0.000～-0.029)시골격기지수강저적주요위험인소.결론 당뇨병환자BMI재괄도초중적범위내유경호적영양상태,유리우예방소기증적발생.
Objective To evaluate the nutritional status and risk factors for sarcopenia in diabetes.Methods 297 diabetic patients who visited nutrition clinic of Beijing Hospital during the period from January 2013 to December 2014 were retrospectively analyzed.The patients were divided into overweight group (BMI ≥ 24.0 kg/m2) and non-overweight group (BMI ≤ 23.9 kg/m2), and the differences in anthropometry, body composition, laboratory indexes, dietary intake were analyzed between these two groups.The risk factors for sarcopenia in diabetes were analyzed by multiple linear regression.Results There were 183 patients in the overweight group and 114 in the non-overweight group.Compared with the overweight group, the left and right hand grip strength [(24.14 ± 7.76) kg vs.(27.78 ± 9.31) kg, P =0.00;(25.55 ± 7.86) kg vs.(28.62 ± 9.55) kg, P =0.01], waist-to-hip rate (0.85 ±0.06 vs.0.92 ± 0.07, P =0.00), arm muscle circumference [(21.45 ±3.73) cm vs.(25.18 ±4.36) cm, P =0.00], the muscle mass [(37.64 ±6.58) kgvs.(45.66±8.92) kg, P=0.00], percentage of body fat [(27.25 ±8.15)％ vs.(35.52 ± 6.56)％, P=0.00], visceral fat area [(71.56±25.28) cm2 vs.(118.84±28.18) cm2, P=0.00],and skeletal muscle index [(6.22 ± 1.17) kg/m2 vs.(7.41 ± 1.25) kg/m2, P =0.00] in the non-overweight group were significantly lower.Hemoglobin and serum glucose level were also significantly lower in the non-overweight group [(136.29 ± 14.81) g/L vs.(141.01 ± 13.47) g/L, P =0.03;(7.08 ± 2.28) mmol/L vs.(7.76 ±2.57) mmol/L, P =0.03].The total protein and albumin levels showed no significant inter-group differences (P =0.15, P =0.52), nor did the energy and protein intakes (P =0.17,P =0.35).The detection rate of sarcopenia was 10.4％ (31/297), which was higher in the non-overweight group than in the overweight group (22.8％ vs.2.7％, P =0.00).Female (B =-1.371, 95％ CI =-1.595--1.146), aging (B=-0.018, 95％ CI=-0.027--0.009), lower BMI (B=-0.115,95 ％ CI =0.092-0.138) , and less energy intake (B =0.014, 95 ％ CI =0.000--0.029) were the major risk factors for skeletal muscle index reduction.Conclusion Moderate overweight as measured by BMI indicates the better nutritional status in diabetes patients compared with non-overweight patients, which might be helpful for the prevention of sarcopenia.
