富含缓释淀粉高单不饱和脂肪酸型肠内营养制剂对糖耐量异常患者糖脂代谢的影响

Effect of enteral nutrition containing slow-release starch and high-monounsaturated-fat on blood glucose and lipid metabolism in patients with impaired glucose tolerance

目的:观察富含缓释淀粉高单不饱和脂肪酸(MUFA)肠内营养(EN)制剂对糖耐量异常(IGT)患者糖脂代谢的影响。方法:62例IGT患者随机分为试验餐组(n=32)和普通餐组(n=30)。试验餐组服用富含缓释淀粉高MUFA的EN制剂(雅培益力佳SR)替代早餐,普通餐组服用等热量的纯牛奶+淡馒头,所有患者分别于干预前和干预4周后检测空腹血糖(FPG)、餐后2 h血糖(PPG)、空腹胰岛素(FINS)、餐后2 h胰岛素(PINS)以及血脂系列,就各项指标进行组内前后比较和组间比较。结果:试验餐组干预4周后体质量以及PPG、PINS、血清甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)均低于干预前,差异有统计学意义(P<0.05或P<0.01);干预后,试验餐组PPG、PINS、TG、TC和LDL-c均低于普通餐组,差异有统计学意义(P<0.01或P<0.05)。结论:富含缓释淀粉高MUFA的EN制剂有利于降低单纯IGT患者PPG和PINS水平,并改善脂质代谢。

Objective： To investigate the effects of enteral nutrition containing slow-release starch and high-monounsaturated-fat on blood and lipid metabolism in patients with impaired glucose tolerance.Methods：Sixty-two patients with impaired glucose tolerance from out-patient clinic were randomized to experimental meal group （Abbott Glucerna SR,n=32） and common breakfast group （isocaloric normal oral diet,n=30）, the fasting plasma glucose, 2-hour postprandial plasma glucose, fasting insulin, 2-hour postprandial insulin, serum lipid pro-ifle were examined before and after 4-week intervention, and the parameters were compared within groups and between groups.Results： The 2-hour postprandial plasma glucose, postprandial serum insulin, serum triglycer-ide, total cholesterol and low-density lipoprotein cholesterol signiifcantly decreased in experimental meal group （P〈0.05 orP〈0.01）, when compared with that of baseline; After 4-week intervention, these parameters were statistically lower than that in common breakfast group （P＆lt;0.01 orP＆lt;0.05）.Conclusion： Dietary consumption of slow-release starch and high-monounsaturated fat can improve glucose metabolism and lipid control in patients with impaired glucose tolerance.