上海市徐汇区中老年2型糖尿病患者膳食钙摄入干预研究

Study on the Intervention of Dietary Calcium Intake Among Middle and Old Age Patients with Type 2 Diabetes Mellitus in Xuhui District,Shanghai

目的 了解上海市徐汇区糖尿病患者食物中钙摄入的情况以及和血糖控制水平的关系,探讨社区居民糖尿病血糖控制的相关因素和干预措施. 方法 采取二阶段分层随机抽样方法,选取上海市徐汇区四家街道社区卫生服务中心60～～75岁在册管理糖尿病患者中抽取单纯2型糖尿病患者共311人进行上门健康问卷调查和实验室相关指标检测,并对干预组给予营养学干预.问卷调查内容包括：基本情况及连续3d24h膳食回顾；体格检查包括测量身高、体重；实验室检查检测静脉和末梢空腹血糖.使用SPSS16.0统计学软件进行统计分析. 结果 糖尿病患者总体钙摄入中位数为524.6（375.5～～733.7）mg/d,摄入达标者仅占调查对象的13.2％.其中男性钙摄入量高于女性（P＜0.05）；干预组干预后钙摄入人群分布情况、钙摄入量与基线相比,差异均有统计学意义（P＜0.01）；钙摄入量和血糖控制水平未见统计学关联（P＞0.05）.干预后总体样本血糖控制不良组钙摄入量高于控制良好组（P＜0.05）. 结论 上海市徐汇区2型糖尿病患者膳食钙摄入量普遍不足,营养干预后糖尿病患者膳食钙结构更为合理,干预效果良好.应加强对社区糖尿病患者尤其是60岁以上女性的膳食干预.

Objective To investigate the calcium intake of middle and old age patients with type 2 diabetes mellitus in Xu- hui district, Shanghai, and to investigate the relationship between calcium intake and plasma glucose level, m as to explore the risk factors and intervention measures. Methods Totally, 311 patients with type 2 diabetes mellitus were recruited by two - stage stratified random sampling from the diabetic patients aged 60 - 75 years registered in 4 community health service centers in Xuhui district, Shanghai. Health questionnaire survey and related laboratory examination were conducted. The patients in the in- tervention group accepted nutrition intervention. The questionnaire survey included items like general condition, education, economic status, medical history and 24 - hours dietary recall for 3 days＇ meals. Their heights and weights were measured, andplasma glucose levels were detected. SPSS 16.0 was used to make statistical analysis. Results The median of the calcium in- take of the patients with type 2 diabetes mellitus was 524.6（P25 --P75 ： 375.5--733.7）rag/day. Only 13.2% of them had quali- fied calcium intake. The calcium intake of the males was significantly higher than that of the females （P〈0.05）. The distribu- tion of the population with various levels of calcium intake and the calcium intake level of the intervention group improved greatly （P〈 0.01 ）. The calcium intake and plasma glucose level did not show statistical correlation（ P 2〉 0.05 ）. After nutrition inter- vention, the calcium intake of the group with poorly controlled plasma glucose were higher than that of the group with well con- trolled plasma glucose （P 〈 0.05）. Conclusions The calcium intake of the patients with type 2 diabetes mellitus in Xuhui district, Shanghai is generally inadequate. After the nutrition intervention, their calcium intake is more reasonable. Dietary inter- vention should be strengthened especially for female patients with type 2 diabetes mellitus older than 60 years.