混合膳血糖指数与老年2型糖尿病患者糖脂代谢的相关性

Association of glycemic index of the mixed food with glucose and lipid metabolism index in elderly patients with type 2 diabetes mellitus

目的探寻混合食物血糖指数（GI）对老年糖尿病患者及糖脂代谢的影响，同时分析不同肥胖度及性别在GI应答效应时的差异。方法采用随机交叉对照法，将43例糖尿病患者分为高GI组和低GI组，予混合膳10周（洗脱期2周），分别于基线、第一阶段后、第二阶段前后测定体重指数（BMI）、果糖胺、胰岛素、C肽和血脂，同时在试验期间监测空腹及餐后毛细血管血糖（3次／周），并记录每日患者代谢膳实际摄入和添加其他食物量，计算每人每日摄入的总能量、三大营养素以及GI总量。结果GI与空腹血糖（FBG）、餐后2h血糖（2hBG）、稳态模型评估的胰岛素抵抗指数（HOMA-IR）、BMI、低密度脂蛋白胆固醇（LDL—C）正相关（r=0．097～0．423，P=0．0001～0．01）；其中超重男性患者的GI值是FBG（β1）和2hBG（胆）回归方程式的强相关因子（β1=0．058，P=0．0001；β2=0．11，P=0．0001）。结论混合膳的GI能较好地反映血糖应答水平，在超重男性患者中尤为明显，并与其他代谢指标也有良好相关性。

Objective To investigate the relationship between glycemic index （GI）of mixed foods and glucose and lipid metabolism index in elderly patients with diabetes mellitus, and to analyze the effects of GI response with regard to sex and obesity. Methods Forty-three patients with diabetes mellitus were divided into two groups with randomly crossover methods：high GI group and low GI group. Mixed meals were given for ten weeks （washing time：2 weeks）. The biochemistry index and anthropometric index at baseline, before and after the first and second phase were measured. At the same time,fasting blood glucose（FBG） and postprandial 2 h blood glucose （2hBG） were supervised thrice a week and the daily energy, three macronutrients,and GI were calculated during trial. Results GI was positively correlated with FBG,2hBG, homeostasis model assessment of insulin resistance （HOMA-IR） ,body mass index （ BMI ）, and low-density lipoprotein cholesterol （ r = 0. 097-0. 423, P = 0. 000 1 - 0.01 ）. GI value was a strong associated factor for FBG and 2hBG in overweight male patients. Conclusions The GI of mixed foods can better reflect the level of glucose response, especially in obese men. And it had good correlations with other metabolic indexes.