营养干预对肥胖伴代谢综合征人群相关指标的影响

目的观察营养干预对肥胖伴代谢综合征人群体成分、血生化指标及血压的改善作用,探讨健康减重的方式。方法体质指数（BMI）≥28．0kg／m^2;男性腰围≥85cm、女性腰围≥80cm;伴有血脂、血压及血糖任两项检查异常的体检肥胖伴代谢综合征患者40例自愿参与本研究,观察营养干预两个月后参与者干预前后体成分、血脂、血糖、血压等指标的变化。统计分析采用SPSS18．0统计软件,计量资料以x^-±s表示,干预前后对比采用配对t检验。结果营养干预进行2个月后参与者体重、体脂肪量、BMI、内脏脂肪面积和腰臀比与干预前比较差异有统计学意义（t=17．02、11．07、5．11、10．35、9．58,P〈0．05）;营养参与者的干预前和干预后丙氨酸氨基转移酶、天冬氨酸氨基转移酶、胆固醇、三酰甘油、空腹血糖、收缩压和舒张压比较差异均有统计学意义（t=2．87、2．91、3．33、2．24、2．56、5．74、6．99,P〈0．05）。结论营养干预的方法通过减重,降低体内脂肪含量,对肥胖患者的血压、血糖和血脂异常有着明显的改善效果,从而降低因肥胖造成的胰岛素抵抗。     

营养干预对2型糖尿病的效果评价

目的探索对中老年２型糖尿病切实有效的营养干预措施。方法 选取临床确诊的非停顿守２型糖尿病患６０例,采用配对设计分为干预组和对照组。干预组除给予药物治疗外还采取膳食指导、营养教育咨询、配制食谱等干预措施,对照组为单纯药物治疗组。结果 采用营养干预措施后干预组与对照组比较,空腹血糖、腹后２小时血糖、糖基化血红蛋白、血清胆固醇、甘油三酯等指标均有显降低。结论 ２型糖尿病患在使用药物治疗同时注意合理     

代谢综合征的营养干预治疗

目的:观察营养干预措施在治疗1个家系代谢综合征(MS)的效果。方法:分析该家系6个家庭66例病人的体重指数(BMI)和血压(BP),并检测血脂和血糖等。随机选取其中3个家庭共34例(干预组)在医学对症处理的基础上,给予一对一指导,改变其不良生活方式和膳食习惯,并进行营养干预。另3个家庭共32例(对照组)仅给予医学对症处理。结果:经营养干预措施3年后,两组病人在BMI、血脂、血糖和需药物干预比例方面,经统计学分析均有显著差异性。随防3年后,干预组病人的体重、血压维持良好,血脂、血糖无反弹。结论:有效的营养干预措施,能改善MS病人的BMI、血脂、血压和血糖。     

糖尿病患者营养干预效果评价

目的 了解营养干预对糖尿病患者的治疗效果,以探索对糖尿病切实有效的营养干预措施.方法 选取临床确诊的门诊糖尿病患者278例,采用配对设计将其分为营养干预组和对照组.在给予药物治疗的同时,营养干预组还采取综合的营养干预措施.干预前后对2组患者进行膳食调查及相关生化指标测定,以观察营养干预的效果.结果 采用营养干预措施后,2组空腹血糖、餐后2 h血糖、糖化血红蛋白、血清胆固醇、甘油三酯等生化指标均降低,但干预组与对照组比较干预组效果更为明显;干预组饮食结构更为合理.结论 当前糖尿病患者群的膳食质量存在问题;糖尿病患者在使用药物治疗同时注意合理饮食和营养,对改善糖尿病临床症状,控制血糖,延缓糖尿病并发症的发生,有明显的促进作用.     

2型糖尿病合并高血压患者的社区综合干预效果评价

目的探讨对2型糖尿病合并高血压患者进行社区综合干预的效果。方法在松江区叶榭社区内确诊的108名2型糖尿病合并高血压患者中,采取随机,对照的方法,分为干预组50例,实行饮食干预、运动干预、药物治疗、血糖血压监测及糖尿病、高血压教育的综合治疗;对照组58例,仅常规药物治疗,历时1年,检测和比较两组干预前后的血压变化,糖尿病生化指标(空腹血糖,餐后2 h血糖,糖化血红蛋白)及血糖、血压控制率。结果经过1年的社区综合干预措施,干预组的收缩压/舒张压,各项血糖指标均较干预前及对照组明显下降,差异有统计学意义(P0.05),而对照组干预前后血压,血糖指标无显著变化(P0.05)。1年后的干预组血糖控制率达到56%,血压达标控制率为38%,明显高于对照组22%的血糖控制率及12%的血压达标率(P0.01)。结论社区综合干预是促进2型糖尿病合并高血压患者得到有效防治的理想手段,值得在社区内积极开展与推广。     

营养咨询干预对体检人群血脂、血压和血糖的影响

目的 了解和分析营养咨询干预对体检人群血脂、血压和血糖的影响.方法 选择2010年在浙江省人民医院体检发现血脂、血压和血糖异常的人群进行营养咨询干预,1年后进行复检分析.结果 营养咨询干预1年后人群血清甘油三酯、总胆固醇、收缩压、舒张压和血糖分别下降20.39%、24.43%、11.32%、13.35%和7.55%;分年龄组分析31~60岁组改善明显,20~30岁及60岁以上年龄组改善不明显.结论 营养咨询干预能改善体检人群异常的血脂、血压和血糖水平,适用于代谢异常人群的干预.     

营养干预对妊娠糖尿病的影响及应用价值探讨

目的探讨和分析营养干预对妊娠糖尿病的影响。方法选取40例在我院接受治疗的妊娠糖尿病患者为分析对象,随机将上述对象分成对照组和观察组;干预组为至少住院一次的患者,对照组在接受相关检查时发现血糖异常,未进行任何饮食指导的患者;观察和分析两者患者的血糖浓度、血压、分娩方式等指标。结果观察组较对照组在空腹血糖、餐后2h血糖、高血压发生率以及巨大儿发生率有显著性降低(P<0.05)。结论对妊娠糖尿病患者进行营养干预,能有效的控制血糖水平,预防并发症的发生,通过借助床边营养宣教的方式对患者进行营养教育,对患者的饮食结构进行护理干预,能帮助患者更好的掌握营养知识,为今后的分娩奠定良好的基础。     

高血压社区健康管理行为干预效果评价

目的探讨高血压患者社区健康管理模式及有效性。方法按照《浙江省社区健康管理行为干预指导手册》要求对60例高血压患者进行强化干预（观察组）,并与一般干预的60例高血压患者（对照组）进行干预效果比较。结果干预后观察组的生活方式评分,体重指数、血压、血糖和廊脂等指标以及血压控制率方面均优于干预前（P〈0．05）。干预后观察组血压控制率为75．00％,对照组为55．93％,两者差异有统计学意义（P〈0．05）。观察组干预后的生活方式评分,体重指数、血压、血糖、血脂等指标以及血压控制率也均优于对照组（P〈0．05）。结论加强高血压患者社区健康管理,能优化患者生活方式,改善各项生化指标及有效控制血压。     

营养干预对妊娠糖尿病的影响及意义

目的探讨妊娠糖尿病营养宣教前后血糖的变化及产褥期并发症的影响。方法将189例妊娠糖尿病患者随机分为干预组和对照组,干预组为至少住院一次的患者,对照组在门诊只做血糖筛查出血糖异常,未作具体饮食指导的患者,同时观察血糖、血脂、血压、分娩方式、是否巨大儿等指标。结果干预组与对照组比较,空腹血糖和餐后2h血糖水平,高血压发生率、以及巨大儿发生率显著降低。营养宣教干预能够让患者掌握营养控制的原则,并且有较好的依从性。结论合理的饮食可有效的控制糖尿病并发症的发生,降低巨大儿的发生率;采用床边营养宣教的方式,结合严格控制饮食,使患者更好的掌握营养知识,量化食物,更直观看到具体食物,从而加深食物量的概念,为顺利分娩打下了良好的基础。     

妊娠期糖尿病实施个性化营养干预的临床观察

目的:探讨妊娠期糖尿病患者实施个性化营养干预效果。方法:选取我院2014年3月至2016年3月门诊就诊的90例妊娠期糖尿病患者,进行糖尿病控制管理,对比患者进行个性化营养干预前后的血糖、血脂、血压及体重控制效果。结果:患者个性化营养干预后的血糖、血脂、血压及体重控制效果均优于个性化营养干预前,差异具有显著统计学意义(P0.05)。结论:给予妊娠期糖尿病患者科学的个性化营养干预,可以显著提高管理效果,改善患者代谢指标,适于临床推广应用。     

A longitudinal study on glucose tolerance and other cardiovascular risk factors: associations within an elderly population.

From 1971 until 1975, 204 patients from a general practice, aged 64-87 at entry, were examined annually. At every examination body weight, serum lipids, and systolic blood pressure were measured, and a complete glucose tolerance test was carried out. Clinically diagnosed diabetics were excluded. Adjusted for age and sex, the annual change in the area under the glucose curve (AUC) was significantly associated with body weight change. Changes in serum total cholesterol, serum triglycerides, and systolic blood pressure were also associated with body weight change. The results were independent of potential confounders such as alcohol use, smoking habits, presence of cardiovascular disease, and baseline levels of the different risk factors. The change in AUC was also associated with changes in serum total cholesterol, independent of confounders such as body weight. Changes in AUC were not related to changes in systolic blood pressure and serum triglycerides. The results of this study suggest that changes in glucose tolerance are not only related to changes in body weight, but also to changes in serum cholesterol.     

Metabolic syndrome and ischemic heart disease in elderly men and women

Associations between metabolic syndrome components and prevalent ischemic heart disease (IHD) were investigated in a cross-sectional, community-based study of elderly men (n = 1,015) and women (n = 1,259) in Rancho Bernardo, California, in 1984-1987. In both sexes, there were significant positive associations between IHD defined by resting electrocardiogram criteria and age, systolic blood pressure, fasting and postchallenge hyperglycemia, total cholesterol/high density lipoprotein cholesterol (HDL cholesterol) ratio, and triglycerides and an inverse significant association with HDL cholesterol. High collinearity and interactions between serum insulin and metabolic syndrome variables were accounted for by uncorrelated principal components identified by factor analysis. In both men and women, three uncorrelated principal components were identified, representing a central metabolic factor (body mass index, fasting and 2-hour serum insulin, high serum triglycerides, and low HDL cholesterol), a glucose factor, and a blood pressure factor. In a multivariate model with age and sex, all three factors were significantly associated with IHD by electrocardiogram criteria; central metabolic factor (odds ratio (OR) = 1.6, p = 0.001), glucose factor (OR = 1.4, p < 0.001), blood pressure factor (OR = 1.2, p = 0.005), age (10 years) (OR = 1.8, p < 0.001), and female sex (OR = 0.5, p < 0.02). Similar results were obtained in analyses using clinically manifest IHD as the outcome. These results support the thesis that the metabolic syndrome exerts effects through different risk factors by different mechanisms.     

Diet and coronary heart disease risk factors in a population with varied intake. The Research Group ATS-RF2 of The Italian National Research Council

The relationship between consumption of foods high in saturated fats and cholesterol and a number of coronary heart disease risk factors (blood pressure, serum glucose, serum cholesterol, and triglycerides) was analyzed in a large sample (4,917) of Italian men and women, ages 20-59 years. The dietary habits of the participants were ascertained with a food frequency questionnaire. Intake of atherogenic foods (foods high in cholesterol and saturated fats) was evaluated for each participant. In both sexes, systolic blood pressure, serum glucose, and serum cholesterol increased with higher consumption of atherogenic foods. These findings were independent of any possible confounding effect of age, adiposity, alcohol intake, and cigarette smoking. The present article confirms previous findings that consumption of foods high in saturated fats and cholesterol is associated with an increased risk for atherosclerosis.     

糖尿病人膳食结构及疾病相关危险因素分析

目的比较糖尿病人 (DM)、空腹血糖受损者 (IFG)与正常人群 (NFG)膳食结构、体检及生化指标的差异 ,探讨糖尿病社区干预的措施。方法横断面调查。内容包括问卷、体检及生化检查。结果检出率 :本次参加调查的 94 3人中共检出糖尿病人 16 8例 (17.8% )、空腹血糖受损者 15 0名 (15 .9% )。血糖异常知晓率 :DM组为 75 .6 % ,IFG组 9.8%。膳食 :DM、IFG和 NFG组总能量平均摄入量分别为 2 2 72、2 5 10和 2 4 70 kcal;脂肪供能比分别为 34%、33.0 %和 33.2 %。体检及生化检查 :DM组和 IFG组血压、血脂水平显著高于正常组 (P<0 .0 5 ) ;肥胖的检出率均显著高于正常组。相关分析显示空腹血糖水平与体质指数、腰围、收缩压、舒张压、血清总胆固醇和甘油三酯呈显著正相关。结论对确诊糖尿病人应加强膳食指导 ,在控制总能量的同时强调降低膳食脂肪摄入量。同时 ,为了降低糖尿病发病率 ,应将 IFG作为重点人群 ,提高 IFG知晓率 ,并积极进行干预。     

以健康食堂为载体的营养健康促进模式的干预效果评价

目的 评价以健康食堂为载体的营养健康促进模式的干预效果,为向其他单位食堂推广应用提供科学依据.方法 于2012年选择江苏省常州市1所创建健康食堂大学的429名教职工为干预组,另1所未采取任何干预措施的947名大学教职工为对照组,此外,干预组进一步按是否经常在食堂就餐分为经常食堂就餐组（≥2次/周）和偶尔食堂就餐组（＜2次/周）;分别在干预前、后（1年）测定血压、体质指数（BMI）,检查脂肪肝发生情况,测定血清中的葡萄糖、总胆固醇、三酰甘油、尿酸、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇;分别进行干预组和对照组间干预前后的对比,并进一步进行干预后干预组中经常食堂就餐组和偶尔食堂就餐组间的对比分析以评价其干预效果.结果干预组干预后的血糖（5.06±0.62） mmol/L、血尿酸（310.57±71.79） μmol/L、血总胆固醇（4.88 ±0.86） mmol/L、血三酰甘油（1.39±0.67）mmol/L及血低密度脂蛋白胆固醇（2.51 ±0.62） mmol/L均显著低于干预前,血高密度脂蛋白胆固醇（1.43 ±0.34） mmol/L显著高于干预前,差异均有统计学意义（t=7.513、2.126、2.062、3.731、8.891、-2.309,P＜0.05）;而对照组干预后的血糖和血尿酸均显著高于干预前,差异有统计学意义（t=-3.491、-7.703,P＜0.01）,血总胆固醇、血三酰甘油、血高密度脂蛋白胆固醇及血低密度脂蛋白胆固醇干预前后差异均无统计学意义（P＞0.05）.干预组干预后的血糖、血尿酸、血总胆固醇、血三酰甘油、血低密度脂蛋白胆固醇、BMI的异常率及高血压发生率均显著低于干预前,差异均有统计学意义（x2=4.202、3.940、4.031、7.305、59.422、4.273、7.385,P＜0.05）;而对照组除干预后血尿酸异常率和脂肪肝发生率均显著高于干预前,差异有统计学意义（x2=23.740、7.408,P＜0.05）外,干预后的血糖、血总胆固醇、血三酰甘油、血低密?     

Serum ionized magnesium levels in relation to metabolic syndrome in type 2 diabetic patients

OBJECTIVE: To evaluate circulating serum ionized magnesium (i-Mg) concentrations in patients with type 2 diabetes mellitus, and to investigate its relationship with the components of the metabolic syndrome. DESIGN: cross-sectional study. SETTING: Outpatients' service for diabetic patients at the University Hospital of Messina, Italy. SUBJECTS: 290 patients with type 2 diabetes mellitus. Measures of Outcome: Serum i-Mg was measured by ion selective electrode. Age, gender, body mass index (BMI), waist circumference, blood pressure, fasting glucose, HbA1c, HDL cholesterol, triglycerides, and urinary albumin excretion rate (UAER) were considered in the analyses. Patients with hypomagnesemia, defined as serum i-Mg <0.46 mmol/l, were compared with those having normal serum i-Mg levels, and variables proven to be associated with low i-Mg levels in the univariate analysis were entered in a multivariable logistic regression model to obtain a deconfounded estimate of the association between metabolic parameters and hypomagnesemia. RESULTS: In univariate analysis, serum i-Mg levels were significantly reduced in patients with low HDL cholesterol, high triglycerides values, high waist circumference, high blood pressure, microalbuminuria and clinical proteinuria. Hypomagnesemia was highly prevalent in our study population (N = 143, 49.3%). After adjusting for potential confounders, plasma triglycerides (OR = 4.71; 95% CI = 2.56-8.67), waist circumference (OR = 2.21; 95% CI = 1.21-4.04), microalbuminuria (OR = 2.43; 95% CI = 1.16-5.08) and clinical proteinuria (OR = 2.04; 95% CI = 1.02-5.68) were independently associated with hypomagnesemia. CONCLUSIONS: Hypomagnesemia is highly prevalent in diabetic outpatients. High plasma triglycerides, waist circumference and albuminuria are independent correlates of hypomagnesemia.     

中老年知识分子血压与健康状况分析

目的：监浊高校知识分子的血压与健康状况。方法：对１４７７名４０岁以上文学、理工、医学和经济学等学科专业的中老年高校教工的血压、身高、体重及相关血液生化指标进行检测,分析对健康的影响。结果：高血压总患病率为１７．６％,单收缩压升高患病率为１３．３％,随增龄而升高。高血压人群的血糖、血清甘油三酯、血尿酸和本质指数（ＢＭＩ）明显高于正常血压的人群,但血清胆固醇浓度在两组之间的差异不显著,与血压有显著直线     

Metabolic Risk Factor Reduction Through A Worksite Health Campaign: A Case Study Design

The purpose of this intervention study was to measure the impact of an onsite and online 12-week worksite heart-health campaign designed to reduce metabolic risk factors for employees at BMW of North America, LLC. All participants received three coaching sessions by a registered dietitian (RD), participated in eight educational sessions led by an RD, viewed their pre, midpoint and final biometric data online, and had access to other web-based tools and educational booklets. The program used team-based competition. At baseline and week 12, blood pressure, anthropometric and hematologic parameters were measured, including changes in weight, blood pressure, fasting blood glucose, waist circumference, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and smoking habits. Of the 100 individuals that enrolled, 95 completed the program, and 87 met criteria to be eligible for data analysis. Paired t tests demonstrated significant reductions in weight (p<.0001), body mass index (p=.0047), waist circumference (p <.0001), diastolic blood pressure (p=.0018), and systolic blood pressure (p=.0012). Paired t tests for total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and fasting blood glucose did not indicate any significant improvements. There was an improvement in body mass index and blood pressure classifications after completion of the program. A Friedman’s test of blood pressure classification demonstrated significant improvements in participants’ blood pressure classification from pre-program to midpoint, midpoint to end, and pre-program to end. These results support the effectiveness of a dietitian-led, team-based, worksite heart-health campaign with web-based education to reduce risk factors for metabolic syndrome.MeSH     

肥胖儿童脂肪肝与其糖脂代谢的初步探讨

目的探讨上海市部分肥胖儿童肥胖程度与脂肪肝发生率的关系以及这些儿童血清部分糖脂代谢指标改变。方法随机筛取1999年至2000年门诊体检儿童100名,同期内分泌门诊就诊单纯性肥胖儿童43名,年龄6~13岁,性别不限,无明显器质性疾病。收集病史资料,测量身高体重,B超检查肝脏,测定血清瘦素、C肽、空腹血糖、血脂(甘油三酯,胆固醇,高密度脂蛋白胆固醇,低密度脂蛋白胆固醇)。按体质指数(BMI)值和有无脂肪肝情况将这些儿童分组。比较各组血清瘦素、C肽、空腹血糖、血脂值有无差异。结果内分泌门诊就诊的肥胖儿童中脂肪肝发生率为13/43,最早发生脂肪肝年龄为7岁。脂肪肝组儿童BMI值明显高于非脂肪肝组儿童(P<0.05)。脂肪肝与非脂肪肝组肥胖儿童血脂、空腹血糖、C肽、瘦素无明显差异(P>0.05)。中重度肥胖儿童血清瘦素、C肽、空腹血糖、血脂(甘油三酯)明显升高(P<0.05)。结论中重度肥胖儿童已发生糖脂代谢紊乱,其中近1/3并发脂肪肝。BMI值可能有助于判断儿童脂肪肝的发生。     

Effects of levonorgestrel-releasing intrauterine system on glucose and lipid metabolism: a 1-year follow-up study

PURPOSE: This prospective study aimed to assess the possible effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on serum lipids and fasting blood glucose levels over a period of 1 year. METHODS: Forty-eight premenopausal women, attending our gynecology clinic with the complaint of menorrhagia, were enrolled in the study. Systolic and diastolic blood pressures were recorded. Serum concentrations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and fasting plasma glucose (FPG) levels were tested before (pretreatment group) and 1 year later following insertion (on-treatment group). Baseline mean parameters were compared with mean parameters at 1 year for statistical significance using paired samples t-test. RESULTS: Thirty-three (68.75%) women were eligible for control in the on-treatment group. Mean age of the patients was 44.34+/-7.59 years. The study results showed that mean FPG level was significantly increased, whereas mean diastolic blood pressure was significantly decreased. Although mean systolic blood pressure tended to decrease and HDL-C concentrations to increase, these changes from baseline levels were insignificant. There were no significant changes in mean TG, TC, VLDL, LDL, AST and ALT. DISCUSSION: The only significant unfavorable effect observed was an increase in FPG level. Since it did not rise to risky values, but alerted us for the high risk patients for glucose intolerance before insertion. The LNG-IUS can be regarded as being safe in their effects on lipid metabolism, blood pressure and liver function tests.