含南瓜籽油膳食对2型糖尿病患者糖脂代谢及营养状况的影响

Changes of glucose and lipid metabolism and nutritional status in type 2 diabetic patients after eating diet containing pumpkin seed oil

目的观察2型糖尿病患者住院配餐中添加南瓜籽油后的临床指标及营养状况的变化。方法采用定点连续采样方法,选择中国人民解放军总医院2014年9月至2015年4月内分泌科住院的2型糖尿病患者78例,其中男性29例,女性49例,年龄(63.05±7.24)岁,按分阶段膳食干预自身对照的研究方法,分为基础膳食(BD)(入院前)、糖尿病膳食(DD)(入院后干预3 d)、南瓜籽油+糖尿病膳食(PODD)(DD后干预7 d)3个阶段,其中,DD干预采用大豆油,25 ml/d;PODD干预采用每日10 ml南瓜籽油+15 ml大豆油。比较各阶段患者临床指标及营养状况的变化情况。观察指标包括血常规(含CRP)、糖代谢指标(血糖、糖化血红蛋白、血清胰岛素)、脂代谢指标(甘油三酯、胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇)、营养指标(身高、体重、体重指数BMI、腰围、臀围、腰臀比、三头肌皮褶厚度、上臂肌围、血白蛋白、总蛋白、铁、总铁结合力,淋巴细胞总数及SGA评分)、其他指标(肝功肾功)。结果 DD和PODD干预后,患者血糖、糖化血红蛋白、甘油三酯、BMI、腰围显低于BD阶段,差异均有统计学意义(P<0.05),而DD和PODD比较,上述指标差异无统计学意义(P>0.05);PODD干预后,患者CRP指标显低于BD阶段(P<0.05),但与DD比较差异无统计学意义(P>0.05);PODD干预后患者的上臂肌围、血清铁、淋巴细胞总数和SGA评分显高于BD和DD阶段(P<0.05),而其他指标三个阶段比较差异均无统计学意义(P>0.05)。结论 2型糖尿病患者营养治疗配餐中适当使用南瓜籽油对血糖、血脂及营养状况具有一定的保护作用。

Objective To observe the changes of clinical and nutritional status in type 2 diabetic patients after eating diet containing pumpkin seed oil. Methods Seventy eight patients with type 2 diabetes mellitus(including 29 males and 49 females) in our hospital from Sep. 2014 to Apr. 2015 were recruited, aged(63.05 ± 7.24) years old. They were provided diets containing three stages, basic diet(BD group, before admission), diabetic diet(DD group, intervention for 3 days after admission), pumpkin seed oil+diabetic diet(PODD group, intervention for 7 days after DD). Patients in DD group were given soybean oil 25 ml/d, and patients in PODD group were given pumpkin seed oil 10 ml+ soybean oil 15 ml/d.The changes of clinical and nutritional status of patients in different stages were compared. The items observed included blood routine examination including C-reactive protein(CRP), glucose metabolism indexes [blood glucose, glycosylated hemoglobin(Hb A1c), serum insulin], lipids metabolism indexes [triglyceride(TG), cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol], nutritional indexes [height, weight, body mass index(BMI), waist circumference, hip circumference, waist to hip ratio, triceps skinfold thickness, mid-upper arm muscle circumference(MUAMC), serum albumin, total protein, Fe, total Fe binding force, lymphocyte count(LC) and SGA score], as well as other indexes(liver function, renal function). Results The levels of blood glucose, Hb A1 c, TG, BMI, wait circumference in DD group and PODD group were significantly lower compared with those in BD group(P<0.05), but no significant difference was found between DD group and PODD group(P>0.05). The level of CRP in PODD group was significantly lower than that in BD group(P<0.05), but showed no statistically significant difference with that of DD group(P>0.05). The levels of MUAMC, Fe, LC and SGA score in PODD group were significantly higher compared with those in BD group and DD group(P<0.05), but other indexes showed no statistically significant difference(P>0.05). Conclusion Eating diet containing pumpkin seed oil may benefit type 2 diabetic patients by improving glucose and lipid metabolism, as well as nutritional status.