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  • 韩婷,曲志华,李伟,等.含缓释碳水化合物肠内营养制剂对老年2型糖尿病合并肥胖患者糖脂代谢及粪短链脂肪酸的影响[J].同济大学学报(医学版),2021,42(4):516-521.    [点击复制]
  • HAN Ting,QU Zhi-hua,LI Wei,et al.Effects of enteral nutrition containing slow-release carbohydrates on glucose and lipid metabolism and fecal short-chain fatty acids in obese elderly patients with T2DM[J].同济大学学报(医学版),2021,42(4):516-521.   [点击复制]
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含缓释碳水化合物肠内营养制剂对老年2型糖尿病合并肥胖患者糖脂代谢及粪短链脂肪酸的影响
韩婷,曲志华,李伟,卓嘉璐,杨宁,陈一秋
0
(同济大学附属第十人民医院临床营养科,上海200072)
摘要:
目的本研究旨在探讨含缓释碳水化合物肠内营养制剂改善老年2型糖尿病(type 2 diabetes mellitus, T2DM)合并肥胖患者血糖、血脂代谢及胰岛功能的作用,及其对患者结肠内短链脂肪酸的影响。方法纳入40例符合入组标准的老年T2DM合并肥胖患者,随机分为干预组和对照组。两组患者均提供个体化的食谱设计和饮食,其中干预组患者的早餐和晚餐均服用含缓释碳水化合物肠内营养制剂,持续8周。记录两组患者干预前后的糖代谢、脂代谢、炎症指标和人体测量指标,并检测患者粪便中的短链脂肪酸的含量。应用SPSS 26.0统计软件进行统计学分析。结果医学营养治疗8周后,与对照组相比,干预组患者的空腹血糖、糖化血红蛋白、三酰甘油、BMI、腰围、腰臀比均有明显降低(P<0.05),C反应蛋白显著降低(P<0.05),空腹胰岛素、空腹血清C肽分泌水平、胰岛素抵抗指数有降低趋势,但差异无统计学意义(P>0.05),粪便中丁酸和总短链脂肪酸的含量显著升高(P<0.05),糖代谢指标与粪短链脂肪酸中的乙酸、丁酸及总短链脂肪酸有相关性(P<0.05)。结论含缓释碳水化合物肠内营养制剂可改善老年T2DM合并肥胖患者血脂代谢、糖代谢和胰岛功能,减轻炎症,同时增加肠道中丁酸浓度。提示含缓释碳水化合物肠内营养制剂可能通过调节肠道中短链脂肪酸的代谢起到改善糖代谢效果。
关键词:  缓释碳水化合物肠内营养制剂  2型糖尿病  肥胖  血糖代谢  短链脂肪酸
DOI:10.12289/j.issn.1008-0392.21076
投稿时间:2021-03-05
基金项目:中国食品科学技术学会食品科技基金—雅培食品营养与安全专项科研基金(2018-18)
Effects of enteral nutrition containing slow-release carbohydrates on glucose and lipid metabolism and fecal short-chain fatty acids in obese elderly patients with T2DM
HAN Ting,QU Zhi-hua,LI Wei,ZHUO Jia-lu,YANG Ning,CHEN Yi-Qiu
(Dept. of Clinical Nutrition, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China)
Abstract:
ObjectiveTo investigate the effects of enteral nutrition containing slow-release carbohydrates on blood glucose metabolism, lipid metabolism, islet function and intestinal short-chain fatty acids in obese elderly patients with type 2 diabetes mellitus(T2DM). MethodsObese elderly patients with T2DM were enrolled in this study. The patients were randomly divided into two groups: 16 patients in the intervention group were given enteral nutrition supplements containing slow-release carbohydrates for breakfast and dinner, lasting for 8 weeks; and 17 patients in control group were given conventional individualized diet. The glucose metabolism, lipid metabolism, inflammatory markers and anthropometry of patients in both groups were recorded before and after intervention, and the content of short-chain fatty acids(SCFA) in feces was detected. SPSS 26.0 software was used for statistical analysis. ResultsCompared with control group, after 8 weeks of medical nutrition therapy, FBG, HbA1C, TG, BMI, waist circumference, waist-hip ratio of the intervention group were significantly decreased(P<0.05). CRP of the intervention group was significantly decreased(P<0.05). FINS, fasting serum C-P levels and insulin resistance index had a decreasing trend(P>0.05). The content of butyric acid and total SCFA in feces were significantly increased(P<0.05). The glucose metabolism index was correlated with acetic acid and butyric acid in fecal SCFAs(P<0.05). ConclusionEnteral nutrition containing slow-release carbohydrates can improve lipid metabolism, glucose metabolism and islet function, reduce inflammation, and increase intestinal butyric acid concentration in obese elderly patients with T2DM. These results suggest that enteral nutrition containing slow-release carbohydrates may improve the effect of glucose metabolism by regulating the metabolism of SCFAs in the intestine.
Key words:  enteral nutrition containing slow-release carbohydrates  type 2 diabetes mellitus obesity  blood glucose metabolism  short-chain fatty acids

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