糖尿病前期人群的醫(yī)學(xué)營養(yǎng)干預(yù)研究
發(fā)布時(shí)間：2018-09-12 09:05
【摘要】：目的:通過對糖尿病前期人群進(jìn)行醫(yī)學(xué)營養(yǎng)干預(yù),改善其糖脂代謝,調(diào)整腸道菌群結(jié)構(gòu),減少或延緩糖尿病等慢性代謝性疾病的發(fā)生與發(fā)展。探索可推廣的防治糖尿病前期的醫(yī)學(xué)營養(yǎng)干預(yù)模式,推動(dòng)對糖尿病前期人群進(jìn)行主動(dòng)干預(yù)。方法:從社區(qū)人群中篩選出符合糖尿病前期診斷標(biāo)準(zhǔn)的研究對象100例,隨機(jī)分成干預(yù)組(50例)和對照組(50例)。對干預(yù)組人群進(jìn)行為期9個(gè)月(共3個(gè)階段)的醫(yī)學(xué)營養(yǎng)干預(yù):(1)干預(yù)第1階段(第1~3月),干預(yù)組人群通過多種方式接受營養(yǎng)宣教、飲食、運(yùn)動(dòng)和心理等醫(yī)學(xué)營養(yǎng)干預(yù)。(2)干預(yù)第2階段(第4~6月),繼續(xù)第1階段干預(yù)的基礎(chǔ)上,對干預(yù)組人群提供膳食纖維粉(10克/日)和低血糖生成指數(shù)(GI)的粗雜糧(50克/日)營養(yǎng)配方干預(yù)食品。(3)干預(yù)第3階段(第7~9月),進(jìn)行與第1階段相同的干預(yù)。對照組人群不采取任何的干預(yù)措施。干預(yù)組人群在每階段干預(yù)前后檢測觀察指標(biāo),對照組人群在整個(gè)試驗(yàn)前后檢測。觀察指標(biāo)包括體重、腰圍(WC)、血壓等生理指標(biāo);血糖、血脂、空腹胰島素(FINS)等血液生化指標(biāo);大腸桿菌、雙歧桿菌、乳酸桿菌的腸道菌群指標(biāo)。分析比較檢測結(jié)果。結(jié)果:1.整個(gè)干預(yù)試驗(yàn)后(9個(gè)月末),干預(yù)組人群的觀察指標(biāo)(收縮壓除外)與試驗(yàn)前(基線)比均明顯改善(P0.05),對照組人群的體重與其基線比明顯升高(P0.05),其余指標(biāo)變化無統(tǒng)計(jì)學(xué)意義(P0.05)。干預(yù)組人群與對照組人群相比,其體重、收縮壓(SBP)、舒張壓(DBP)、空腹血糖(FPG)、餐后2h血糖(2h PG)、糖化血紅蛋白(Hb A1c)、甘油三酯(TG)、FINS、HOMA-IR明顯下降(P0.05),腸道有益菌雙歧桿菌數(shù)明顯升高(P0.05)。2.干預(yù)第1階段末,干預(yù)組人群的少數(shù)指標(biāo)(體重、WC、2h PG)與基線比明顯改善(P0.05),其余指標(biāo)多數(shù)有改善趨勢,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3.干預(yù)第2階段末,干預(yù)組人群的絕大多數(shù)觀察指標(biāo)與第1階段末比明顯改善,其中體重、WC、DBP、FPG、2h PG、Hb A1c、TC、TG、LDL-C、FINS、HOMA-IR、大腸桿菌數(shù)明顯下降(P0.05),而腸道有益菌乳酸桿菌數(shù)、雙歧桿菌數(shù)明顯升高(P0.05),HDL-C、SBP有改善趨勢,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。4.干預(yù)第3階段末,干預(yù)組人群的腸道有益菌雙歧桿菌數(shù)與第2階段末比明顯下降(P0.05),但其余指標(biāo)變化均不明顯(P0.05)。與第1階段末相比,干預(yù)組人群的絕大多數(shù)觀察指標(biāo)仍明顯改善,其中體重、WC、DBP、FPG、2h PG、Hb A1c、TC、TG、LDL-C、FINS、HOMA-IR、大腸桿菌數(shù)明顯下降(P0.05),乳酸桿菌數(shù)和雙歧桿菌數(shù)明顯升高(P0.05)。5.試驗(yàn)后,干預(yù)組中29人(63.0%)血糖轉(zhuǎn)歸正常,1人(2.2%)進(jìn)展為糖尿病;對照組中5人(10.6%)血糖恢復(fù)正常,6人(12.8%)進(jìn)展為糖尿病,兩組轉(zhuǎn)歸率差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.醫(yī)學(xué)營養(yǎng)干預(yù)能改善糖尿病前期人群的糖脂代謝,減輕胰島素抵抗,降低其體重、腰圍和血壓,延緩和避免糖尿病前期進(jìn)展為糖尿病。2.醫(yī)學(xué)營養(yǎng)干預(yù)能調(diào)整糖尿病前期人群的腸道菌群結(jié)構(gòu),扶持有益腸道菌,壓制條件致病菌,恢復(fù)腸道微生態(tài),阻止或延緩糖尿病等慢性代謝性疾病的發(fā)生發(fā)展。3.膳食纖維和低GI粗雜糧營養(yǎng)配方干預(yù)食品對糖尿病前期人群的糖脂代謝、腸道菌群結(jié)構(gòu)等起改善作用。
[Abstract]:OBJECTIVE: To explore a popularizable medical nutrition intervention model for the prevention and treatment of diabetes mellitus and to promote active intervention in the pre-diabetic population by improving glucose and lipid metabolism, adjusting intestinal flora structure, reducing or delaying the occurrence and development of chronic metabolic diseases such as diabetes mellitus. 100 subjects were randomly divided into intervention group (50 cases) and control group (50 cases). Medical nutrition intervention was carried out in intervention group for 9 months (a total of 3 stages): (1) intervention stage 1 (1-3 months), intervention group received nutrition education, diet, transportation through a variety of ways. Medical nutritional intervention such as exercise and psychology. (2) Intervention stage 2 (4-6 months), on the basis of continuing intervention stage 1, dietary fiber meal (10 g/day) and hypoglycemic index (GI) of coarse grains (50 g/day) nutritional formula intervention food were provided to the intervention group. (3) Intervention stage 3 (7-9 months), the same intervention as stage 1. Intervention group was tested before and after each intervention stage, and control group was tested before and after the whole experiment. Observation indexes included body weight, waist circumference (WC), blood pressure, blood glucose, blood lipids, fasting insulin (FINS) and other blood biochemical indicators; Escherichia coli, bifidobacterium, lactobacillus. Intestinal flora indicators. Analysis and comparison of the results. Results: 1. After the whole intervention test (9 months end), the intervention group of population observation indicators (except systolic blood pressure) and pre-test (baseline) were significantly improved (P 0.05), the control group of population weight and its baseline ratio increased significantly (P 0.05), the other indicators were not statistically significant (P 0.05). Compared with the control group, the body weight, SBP, DBP, FPG, 2H PG, Hb A1c, TG, FINS, HOMA-IR were significantly decreased (P 0.05), and the number of intestinal beneficial bacteria bifidobacteria was significantly increased (P 0.05). 2. At the end of the first intervention stage, a few indicators (body weight, WC, 2H PG) were found in the intervention group. At the end of the second stage, the majority of the observed indexes in the intervention group were significantly improved compared with the end of the first stage, including body weight, WC, DBP, FPG, 2H PG, Hb A1c, TC, TG, LDL-C, FINS, HOMA-IR, and E. coli count decreased significantly (P 0.05). The number of intestinal beneficial bacteria, lactobacillus, Bifidobacterium significantly increased (P 0.05), HDL-C, SBP had an improvement trend, but there was no significant difference (P 0.05). 4. At the end of the third intervention stage, the number of intestinal beneficial bacteria in the intervention group was significantly lower than that at the end of the second stage (P 0.05), but the other indicators did not change significantly (P 0.05). The overwhelming majority of the observed indicators in the intervention group were still significantly improved, including body weight, WC, DBP, FPG, 2H PG, Hb A1c, TC, TG, LDL-C, FINS, HOMA-IR, E. coli count decreased significantly (P 0.05), Lactobacillus count and bifidobacteria count increased significantly (P 0.05). After the experiment, 29 (63.0%) of the intervention group returned to normal blood glucose, and 1 (2.2%) of the control group developed diabetes. 5 (10.6%) of the patients recovered to normal blood glucose and 6 (12.8%) developed diabetes mellitus. There was a significant difference in the prognosis between the two groups (P 0.05). Conclusion: 1. Medical nutrition intervention can improve glucose and lipid metabolism, reduce insulin resistance, reduce body weight, waist circumference and blood pressure, delay and avoid the development of diabetes mellitus. Nutritional intervention can adjust the intestinal flora structure of pre-diabetic population, support beneficial intestinal bacteria, suppress conditional pathogenic bacteria, restore intestinal microecology, prevent or delay the occurrence and development of chronic metabolic diseases such as diabetes. 3. Dietary fiber and low GI coarse grain nutritional formula intervention food on glycolipid metabolism of pre-diabetic population, intestinal bacteria. Group structure plays an important role in improving.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1
本文編號(hào)：2238544
[Abstract]:OBJECTIVE: To explore a popularizable medical nutrition intervention model for the prevention and treatment of diabetes mellitus and to promote active intervention in the pre-diabetic population by improving glucose and lipid metabolism, adjusting intestinal flora structure, reducing or delaying the occurrence and development of chronic metabolic diseases such as diabetes mellitus. 100 subjects were randomly divided into intervention group (50 cases) and control group (50 cases). Medical nutrition intervention was carried out in intervention group for 9 months (a total of 3 stages): (1) intervention stage 1 (1-3 months), intervention group received nutrition education, diet, transportation through a variety of ways. Medical nutritional intervention such as exercise and psychology. (2) Intervention stage 2 (4-6 months), on the basis of continuing intervention stage 1, dietary fiber meal (10 g/day) and hypoglycemic index (GI) of coarse grains (50 g/day) nutritional formula intervention food were provided to the intervention group. (3) Intervention stage 3 (7-9 months), the same intervention as stage 1. Intervention group was tested before and after each intervention stage, and control group was tested before and after the whole experiment. Observation indexes included body weight, waist circumference (WC), blood pressure, blood glucose, blood lipids, fasting insulin (FINS) and other blood biochemical indicators; Escherichia coli, bifidobacterium, lactobacillus. Intestinal flora indicators. Analysis and comparison of the results. Results: 1. After the whole intervention test (9 months end), the intervention group of population observation indicators (except systolic blood pressure) and pre-test (baseline) were significantly improved (P 0.05), the control group of population weight and its baseline ratio increased significantly (P 0.05), the other indicators were not statistically significant (P 0.05). Compared with the control group, the body weight, SBP, DBP, FPG, 2H PG, Hb A1c, TG, FINS, HOMA-IR were significantly decreased (P 0.05), and the number of intestinal beneficial bacteria bifidobacteria was significantly increased (P 0.05). 2. At the end of the first intervention stage, a few indicators (body weight, WC, 2H PG) were found in the intervention group. At the end of the second stage, the majority of the observed indexes in the intervention group were significantly improved compared with the end of the first stage, including body weight, WC, DBP, FPG, 2H PG, Hb A1c, TC, TG, LDL-C, FINS, HOMA-IR, and E. coli count decreased significantly (P 0.05). The number of intestinal beneficial bacteria, lactobacillus, Bifidobacterium significantly increased (P 0.05), HDL-C, SBP had an improvement trend, but there was no significant difference (P 0.05). 4. At the end of the third intervention stage, the number of intestinal beneficial bacteria in the intervention group was significantly lower than that at the end of the second stage (P 0.05), but the other indicators did not change significantly (P 0.05). The overwhelming majority of the observed indicators in the intervention group were still significantly improved, including body weight, WC, DBP, FPG, 2H PG, Hb A1c, TC, TG, LDL-C, FINS, HOMA-IR, E. coli count decreased significantly (P 0.05), Lactobacillus count and bifidobacteria count increased significantly (P 0.05). After the experiment, 29 (63.0%) of the intervention group returned to normal blood glucose, and 1 (2.2%) of the control group developed diabetes. 5 (10.6%) of the patients recovered to normal blood glucose and 6 (12.8%) developed diabetes mellitus. There was a significant difference in the prognosis between the two groups (P 0.05). Conclusion: 1. Medical nutrition intervention can improve glucose and lipid metabolism, reduce insulin resistance, reduce body weight, waist circumference and blood pressure, delay and avoid the development of diabetes mellitus. Nutritional intervention can adjust the intestinal flora structure of pre-diabetic population, support beneficial intestinal bacteria, suppress conditional pathogenic bacteria, restore intestinal microecology, prevent or delay the occurrence and development of chronic metabolic diseases such as diabetes. 3. Dietary fiber and low GI coarse grain nutritional formula intervention food on glycolipid metabolism of pre-diabetic population, intestinal bacteria. Group structure plays an important role in improving.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1
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