| 摘要: |
| 目的探讨不同血糖水平下膳食营养素尤其是膳食钙含量与2型糖尿病（T2DM）患者糖代谢及相关生化指标的相关性。方法将207例T2DM患者按照糖化血红蛋白（HbA1c）水平分为3组：血糖控制较好组（40例）、血糖控制一般组（65例）、血糖控制较差组（102例）。比较3组患者临床特征、血糖水平、膳食能量和主要营养素摄入及供能情况之间的差异，并对影响血钙水平的膳食因素和生化指标行多元逐步回归分析。结果血糖控制较好组与血糖控制一般、较差组比较，摄入的膳食钙[（524.14±320.01）mg/L对（384.68±221.43）mg/L、（481.23±299.65）mg/L]、磷[（989.03±482.82）g对（761.79±333.93）g、（852.85±373.15）g]、蛋白质[（78.87±42.54）g对（56.85±24.07）g、（66.76±31.33）g]均明显增高（均P＜0.05），甲状旁腺素（PTH）、空腹血糖（FPG）均明显降低（均P＜0.05）。多元逐步回归分析结果显示，影响校正钙值的主要膳食因素为脂肪（茁=0.203，P＜0.05），主要临床特征因素是骨特异性碱性磷酸酶、FPG、空腹胰岛素、胰岛素抵抗指数、总胆固醇、25-羟基维生素D（茁=-0.301、0.490、2.225、-1.800、0.211、0.281，均P＜0.05）。结论T2DM患者由糖代谢紊乱引起钙、磷丢失增多，吸收障碍，以及膳食中钙摄入不足，可引发代谢性骨病。 |
| 关键词: 2 型糖尿病 膳食钙 HbA1c 25- 羟基维生素 D |
| DOI：10.12056/j.issn.1006-2785.2017.39.12.2017-395 |
| 分类号: |
| 基金项目:浙江省医药卫生一般研究计划（2015KYB225） |
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| Relationship between dietary nutrients and serum calcium, glycometabolism in patients with type 2 diabetes mellitus |
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CHEN Aijiao, HU Zhefang, FENG Lijun
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Wenzhou Municipal TCM Hospital
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| Abstract: |
| Objective To explore the relationship between the dietary nutrients and serum calcium, glucose metabolism in patients with type 2 diabetes mellitus (T2DM). Methods Two hundred and seven T2DM patients were divided into three groups according to their HbA1C levels, glycemic well-controlled group (40 cases), moderately-controlled group (65 cases) and poorly-controlled group (102 cases). The clinical features, blood glucose levels, the dietary nutrients and energy intake were compared among three groups. The correlation of dietary nutrients with the serum calcium(CsCa) level and biochemical indices of glucose metabolism was analyzed by multiple stepwise regression. Results Compared with moderately and poorly-glycemic
controlled groups, the intakes of dietary calcium [(524.14±320.01) mg/L vs (384.68±221.43) mg/L,(481.23±299.65)mg/L, P＜
0.05], bone phosphorus [(989.03±482.82)g vs (761.79±333.93)g, (852.85±373.15)g, P＜0.05]and protein[(78.87±42.54)g vs (56.85±24.07)g, (66.76±31.33)g, P＜0.05]in well-controlled group were higher, while the levels of parathyroid hormone (PTH) and fasting plasma glucose (FPG) were lower. Multiple stepwise analysis indicated that dietary fat was correlated with CsCa (茁=0.203, P＜0.05). Specific alkaline phosphatase(BSAP), FPG, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, 1,25- (OH)2D3 were independently correlated with CsCa (茁=-0.301, 0.490, 2.225, -1.800, 0.211 and 0.281 respectively, all P＜0.05). Conclusion T2DM patients may lead to loss of the calcium and phosphorus, and insufficient intake of dietary calcium may result to metabolic bone disease. |
| Key words: Type 2 diabetes mellitus dietary calcium HbA1C 1,25-(OH)2D3 |
