抗性淀粉长期干预对2型糖尿病患者糖脂代谢的影响

Effects of long-term intervention of resistant starch on saccharometabolism and lipid metabolism in patients with type 2 diabetes mellitus

目的观察抗性淀粉(resistant starch,RS)长期干预对2型糖尿病(type 2 diabetes mellitus,T2DM)患者糖脂代谢的影响。方法纳入2015年6月至2016年6月上海中医药大学附属曙光医院内分泌科住院部确诊T2DM的患者60例,随机分为观察组及对照组,每组30例,分别给予RS饼干及日常饮食,均干预12周,每4周随访1次。比较并分析干预前后糖代谢指标[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2hBG)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)]、脂代谢指标[总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)]、空腹胰岛素(fasting insulin,FINS)及稳态模型胰岛素抵抗指数。结果干预前,两组TC、HDL-C比较差异具有统计学意义(P<0.05)。干预后,对照组FBG、HbA1c较干预前均降低(P<0.05)。观察组FBG、2hBG、HbA1c均降低(P<0.05),TG、TC、LDL-C均降低(P<0.05)。干预第8周,两组FBG、2hBG分别较干预第4周时显著下降(P<0.05)。与对照组相比,观察组TC、LDL-C差值高于对照组(P<0.05)。结论长期服用RS可改善T2DM患者糖脂代谢紊乱情况,可作为T2DM的营养治疗方案之一。

Objective To observe the effects of long-term intervention of resistant starch(RS)on saccharometabolism and lipid metabolism in patients with type 2 diabetes mellitus(T2DM).Methods A total of 60 patients with T2DM diagnosed in the inpatient department of endocrinology of Shuguang hospital affiliated to Shanghai university of traditional Chinese medicine,from June 2015 to June 2016,were randomly divided into observation group and control group,with 30 cases in each group.The observation group was given RS biscuits and control group was given daily diet for 12 weeks,followed up once every 4 weeks.The indexes of saccharometabolism[fasting blood glucose(FBG),2-hour postprandial blood glucose(2hBG),glycosylated hemoglobin A1c(HbA1c)],lipid metabolism[total cholesterol(TC),triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)],fasting insulin and homeostasis model assessment of insulin resistance(HOMA-IR)were compared and analyzed before and after intervention.Results Before intervention,there was significant difference in TC and HDL-C between the two groups(P<0.05).After the intervention,FBG and HbA1c in the control group were lower than those before the intervention(P<0.05).In the observation group,FBG,2hBG and HbA1c were all decreased(P<0.05),TG,TC and LDL-C were all decreased(P<0.05).At the 8th week of intervention,FBG and 2hBG in the two groups were significantly lower than that at the 4th week of intervention(P<0.05).Compared with the control group,the difference of TC and LDL-C in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Long-term administration of RS can improve the disorder of saccharometabolism and lipid metabolism in patients with T2DM,which can be used as one of the nutritional treatment schemes of T2DM.