超重与肥胖2型糖尿病患者的膳食结构调查分析

Dietary pattern in overweight and obese patients with type 2 diabetes mellitus

目的调查分析超重与肥胖2型糖尿病(T2DM)患者的膳食结构,为糖尿病的个体化医学营养治疗提供依据。方法选取2017年1月至6月住院T2DM患者103例为调查对象(男58例,女45例,年龄≥25岁),根据体质指数(BMI)分为3组:18.5<BMI<24.0 kg/m^2为正常组(31例),24.0WBMK 28.0 kg/m^2为超重组(38例).BMI≥28kg/m2为肥胖组(34例)。每个调查对象采用称重法进行3×24 h膳食记录,测量身高、体重、腰围等,并应用营养分析软件计算调查对象的日均摄入总能量、三大营养素供能比、三大营养素及膳食纤维摄入量等。多组间比较采用单因素方差分析。结果(1)总能量:三组总能量摄入差异有统计学意义(F=4.321,P<0.05);肥胖组总能量摄入高于正常组:[(2488±894)比(2094±346)kcal(1 kcal=4.18 kJ),P<0.05];超重组[(2172±314)kcal]与正常组、肥胖组差异无统计学意义(均P>0.05).(2)供能比:三组碳水化合物、蛋白质和脂肪供能比结果差异均无统计学意义(均P>0.05).(3)摄入量:三组碳水化合物摄入量肥胖组高于正常组、超重组[分别为(332±114)、(265±52)、(276±60)g,均P<0.05],差异有统计学意义(F=6.755,P<0.05);超重组与正常组差异无统计学意义(P>0.05)。三组蛋白质、脂肪、膳食纤维摄入量差异均无统计学意义(均P>0.05)。结论与体重正常者相比,肥胖T2DM患者日均总能量摄入超量,主要是碳水化合物摄入过多。

Objective The characteristics of dietary structure in overweight/obese type 2 diabetic patients were investigated for providing individualized medical nutrition therapy for diabetes mellitus.Methods A total of 103 out-patients(58 males,45 females,$25 years)from the 900 Hospital of the Joint Logistics Team between January and June in 2017 were recruited and divided into 3 groups according to body mass index(BMI):normal group(18.5<BMl<24.0 kg/m2,n=31),overweight group(24.0W BMl<28.0 kg/nr,n=38)and obese group(BMI^28.0 kg/m2,n=34).3x24 hours dietary records were collected by weighing method including height,weight and waist circumference measuring.Mean daily intakes of total calorie,energy supply ratio of three major nutrients,intake of three major nutrients and dietary fiber were calculated and analyzed by software of trophic analysis.One-way analysis of variance was used for comparison among multiple groups.Results(1)Total calorie intake:the differences of total calorie intake among 3 groups were statistically significant(F=4.321,P<0.05);it was higher in the obese group than that in the normal group[(2488±894)vs(2094±346)kcal(1 kcal=4.18 kJ),P<0.05];while there were no significant differences between the overweight group and the normal group or the obese group(both P>0.05).(2)Energy supply ratio:there were no significant differences in energy supply ratio of carbohydrate,protein and fat among 3 groups(all P>0.05).(3)Intake:differences were significant in the carbohydrate intake among 3 groups(F二6.755,P<0.05),intake in the obese group was higher than those in the normal group or the overweight group[(332±114)vs(265±52)vs(276±60)g,all P<0.05].There was no significant difference between the normal and the overweight group(P>0.05).There were no significant differences in protein,fat and dietary fiber intake among 3 groups(all P>0.05).Conclusion Compared with normal weight patients with type 2 diabetics,obese type 2 diabetic patients have excessive daily energy intakes and excess energies,mainly due to excessive carbohydrate intake.