Bouguerra R, Jabrane J, Maâtki C, Ben Salem L, Hamzaoui J, El Kadhi A, Ben Rayana C, Ben Slama C
Service d'Endocrinologie, Métabolisme et Nutrition, Institut national de Nutrition, 11, rue Djebel Lakhdar - Bab Saadoun 1007 Tunis, Tunisie.
Ann Endocrinol (Paris). 2006 Mar;67(1):54-9. doi: 10.1016/s0003-4266(06)72541-0.
This study was designed to assess the effects of fasting during Ramadan on weight, blood pressure, metabolic control and plasma lipoproteins in diabetic patients. This study was conducted in December 2000 (Ramadan 1421) when the length of fasting was 12 hours a day. It included 38 type 2 diabetic patients (20 males and 18 females). Mean patient age was 51.410.5 years and mean body mass index (BMI) 28.94.7kg/m2. Three patients were treated with diet and 35 with oral hypoglycemic agents. Clinical and biochemical parameters were evaluated during three periods: three weeks before Ramadan (T0), at the fourth week of Ramadan (T1) and three weeks after the end of Ramadan (T2). During the month of Ramadan, a decrease in weight (0.52kg) and no change in blood pressure were observed. No metabolic complication occurred in our patients. A significant effect of Ramadan fasting was observed on glycemic control and lipoprotein levels. In patients whose fructosamine level before Ramadan was higher than 340micromol/l, plasma fasting glucose and serum fructosamine increased during Ramadan (p<0.003) and returned to initial levels at the end of Ramadan T2; in these patients also, a decrease of HDL-cholesterol (p<0.01) associated with an increase of LDL-cholesterol (p<0.003) were observed at T1 and disappeared at T2. But, in patients whose fructosamine level at T0 was lower than 340micromol/l, no effect on glycemic control and no significant effect on serum lipoprotein levels were found during Ramadan month. Ramadan fasting in type 2 diabetic patients seems to cause slight effects on glycemia and lipoprotein levels when previous metabolic control is quite good; but fasting induces more deterioration when previous control is poor.
本研究旨在评估斋月期间禁食对糖尿病患者体重、血压、代谢控制及血浆脂蛋白的影响。本研究于2000年12月（伊历1421年斋月）进行，当时每日禁食时长为12小时。研究纳入了38例2型糖尿病患者（20例男性和18例女性）。患者平均年龄为51.4±10.5岁，平均体重指数（BMI）为28.9±4.7kg/m²。3例患者接受饮食治疗，35例患者接受口服降糖药治疗。在三个时间段对临床和生化参数进行评估：斋月前3周（T0）、斋月第4周（T1）和斋月结束后3周（T2）。在斋月期间，观察到体重下降（0.52kg）且血压无变化。我们的患者未发生代谢并发症。观察到斋月禁食对血糖控制和脂蛋白水平有显著影响。在斋月前果糖胺水平高于340微摩尔/升的患者中，斋月期间空腹血糖和血清果糖胺升高（p<0.003），并在斋月结束时的T2恢复至初始水平；在这些患者中，T1时还观察到高密度脂蛋白胆固醇降低（p<0.01），同时低密度脂蛋白胆固醇升高（p<0.003），而在T2时消失。但是，在T0时果糖胺水平低于340微摩尔/升的患者中，斋月期间未发现对血糖控制有影响，对血清脂蛋白水平也无显著影响。2型糖尿病患者在先前代谢控制良好时，斋月禁食似乎对血糖和脂蛋白水平有轻微影响；但如果先前控制不佳，禁食会导致更多恶化。
