社区2型糖尿病患者HbA1c水平与营养状况的关系研究

目的 探讨社区2型糖尿病患者HbA1c与营养状况的关系.方法 将219例社区2型糖尿病患者以HbA1c水平分为2组,HbA1c<6.5%组108例、HbA1c≥6.5%组111例.分别比较两组的血压、血糖、血脂和胰岛素抵抗指数水平,以及膳食结构和营养素摄入情况.结果 (1)社区2型糖尿病患者HbA1c<6.5%者占49.32%;(2)HbA1c与空腹血糖、餐后血糖、稳态模型评估的胰岛素抵抗指数(HOMA-IR)水平呈正相关(r分别为0.56、0.49、0.20,P<0.05或P<0.01),与高密度脂蛋白胆同醇呈负相关(r=-0.16,P<0.05);(3)营养素摄入量与HbA1c的关系表现为:能量、碳水化合物、蛋白质和总脂肪是影响HbA1c的独立相关因素(均P<0.05);(4)与≥6.5%组相比,HbA1c<6.5%组摄入较多水果.≥6.5%组纯能量类食物摄入过多,且蛋白质、总脂肪和饱和脂肪酸摄入量多于HbA1c<6.5%组(P<0.05);(5)拟合线性回归模型发现:摄入较多粗粮杂豆、水果分别使HbA1c均值降低0.36%(P<0.10)、0.46%(P<0.01);适量减少畜肉、油脂摄入量平均使HbA1c降低0.42%(P<0.05)、0.37%(P<0.10).结论 目前社区2型糖尿病患者HbA1c<6.5%者比例不高,HbA1c<6.5%者与HbA1c>≥6.5%者的营养状况差异明显,饮食对HbA1c的影响较大,因此应对2型糖尿病患者进行合理的饮食治疗,尽早实现糖尿病控制达标.     

饮食莫钻“牛角尖”

众所周知,饮食疗法是糖尿病治疗的基础,合理的饮食有助于降低血糖、控制体重、减轻胰岛B细胞的负担。少数症状较轻的糖尿病病友甚至只需控制饮食便能维持血糖正常。由此可见饮食治疗的重要性。但是,许多病友在饮食治疗的认识上仍然存在着种种误区,并因此影响了病情的控制和生活质量。尤其一些老年病友,由于缺乏正确的糖尿病知识,可能存在一些错误的观念和认识,糖尿病饮食控制的效果往往不尽人意。     

社区2型糖尿病患者HbA1c水平与营养状况的关系研究

Objective To explore the possible correlation between HbA1c level and nutritional status in community.based patients with type 2 diabetes.Methods A totaI of 219 type 2 diabetes patients were assigned into 2 groups:one with HbAIc<6.5%(n:108)and HbA1f≥6.5%(n=111).Metabolic parameters,food components.and nutritional status were compared between 2 groups.Results (1)49.32% of the participants attained HbA1c<6.5%.(2)HbA1c level was positively correlated with fasting plasma glucose,postprandial plasma glucose,and homeostasis assessment for insulin resistance(HOMA-IR)(r were 0.56,0.49,and 0.20,respectively,P<0.05 or P<0.01),but negatively correlated with high-density lipoprotein-cholesterol(HDL-C)(r=0.16,P<0.05).(3)Linear regression analysis showed that energy,carbohydrate,protein,and fat were the independent risk factors of HbA1c(all P<0.05).(4)Patients with HbA1c<6.5%consumed more fruits.The intake of pure energy-providing foods and protein-,fat-,or saturated fatty acid-rich foods were more frequent in patients with HbA1c≥6.5%(P<0.05).(5)The linear regression revealed that HbA1c level were decreased 0.36%(P<0.10)or 0.46%(P<0.01)by intake of more fruits,roughage and beans,and HbA1c levels were also decreased 0.42%(P<0.05)or 0.37%(P<0.10)by intake of less meat or oils.Conclusions In communitybased patients with type 2 diabetes mellitus,the incidence of HbA1c<6.5% remains low,There exists great difference in nutritional status between the groups with high and low HbA1c levels.The impact of diet OB HbA1c level is great.It's necessary to emphasize the importance of diet therapy far better diabetes control.     

代谢当量在评估体力活动强度及健康效应中的应用

随着生活节奏的加快,运动的减少,慢性疾病的发病率越来越高。研究表明,运动越多的人,罹患慢性疾病死亡的危险性越低。本文就国际广泛认可的体力活动强度评价方法代谢当量(METs)的概念及国内外对其的研究做一综述,探求其在减轻体重和防治慢性疾病中的应用。     

社区2型糖尿病患者HbA1c水平与营养状况的关系研究

Objective To explore the possible correlation between HbA1c level and nutritional status in community.based patients with type 2 diabetes.Methods A totaI of 219 type 2 diabetes patients were assigned into 2 groups:one with HbAIc<6.5%(n:108)and HbA1f≥6.5%(n=111).Metabolic parameters,food components.and nutritional status were compared between 2 groups.Results (1)49.32% of the participants attained HbA1c<6.5%.(2)HbA1c level was positively correlated with fasting plasma glucose,postprandial plasma glucose,and homeostasis assessment for insulin resistance(HOMA-IR)(r were 0.56,0.49,and 0.20,respectively,P<0.05 or P<0.01),but negatively correlated with high-density lipoprotein-cholesterol(HDL-C)(r=0.16,P<0.05).(3)Linear regression analysis showed that energy,carbohydrate,protein,and fat were the independent risk factors of HbA1c(all P<0.05).(4)Patients with HbA1c<6.5%consumed more fruits.The intake of pure energy-providing foods and protein-,fat-,or saturated fatty acid-rich foods were more frequent in patients with HbA1c≥6.5%(P<0.05).(5)The linear regression revealed that HbA1c level were decreased 0.36%(P<0.10)or 0.46%(P<0.01)by intake of more fruits,roughage and beans,and HbA1c levels were also decreased 0.42%(P<0.05)or 0.37%(P<0.10)by intake of less meat or oils.Conclusions In communitybased patients with type 2 diabetes mellitus,the incidence of HbA1c<6.5% remains low,There exists great difference in nutritional status between the groups with high and low HbA1c levels.The impact of diet OB HbA1c level is great.It's necessary to emphasize the importance of diet therapy far better diabetes control.     

补充铁剂对上海老年人缺铁性贫血的改善效果

目的观察铁剂纠正老年人缺铁性贫血的效果,为开展老年入缺铁性贫血防治工作提供参考依据。方法招募缺铁性贫血的老年人62例（男性16例,女性46例）,年龄60-79岁,每日口服一包铁营养包（主要成分为焦磷酸铁和富马酸亚铁,含元素铁8mg）,连续服用6个月,分别于干预前、第3个月、第6个月进行贫血相关指标,血清铁蛋白及C反应蛋白测定观察补铁效果,同时进行膳食调查。结果经过6个月干预,老年人血红蛋白水平由112．5g／L上升至114．4g／L,血红蛋白达标率（32．3％）、红细胞计数、平均红细胞浓度、血清铁蛋白达标率（83．9％）基线调查水平差异有统计学意义（P〈0．01）。试验期间老年人能量及有关营养素摄取量差异无统计学意义。结论连续6个月每日补充8mg铁能有效改善老年人缺铁性贫血。     

2型糖尿病患者血尿酸水平与肾脏早期损害关系的研究

探讨2型糖尿病患者的血尿酸水平与肾脏早期损害指标尿白蛋白尿肌酐比(ACR)之间的关系.高尿酸组中ACR的超标率显著高于尿酸正常组(P＜0.01).ACR与尿酸水平呈正相关(P＜0.01).多元线性回归表明ACR是尿酸的主要影响因素.2型糖尿病患者合并高尿酸者存在ACR超标,更易出现肾脏早期损害.

Abstract：

The association of serum uric acid ( SUA ) and urine albumin-to-creatinine ratio ( ACR ) in patients with type 2 diabetes mellitus was explored. The ACR abnormal rate was higher in hyperuricemia group( P＜0.01 ). ACR level was positively correlated with SUA( P＜0.01 ). The general linear model showed that SUA was a risk factor in ACR. Patients with hyperuricemia and type 2 diabetes mellitus were apt to have abnormal ACR and develop early renal damage.