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2型糖尿病患者的饮食模式与健康结局

Eating Patterns and Health Outcomes in Patients With Type 2 Diabetes.

作者信息

Sarmento Roberta Aguiar, Antonio Juliana Peçanha, de Miranda Ingrid Lamas, Nicoletto Bruna Bellicanta, de Almeida Jussara Carnevale

机构信息

Endocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil.

Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

J Endocr Soc. 2017 Nov 17;2(1):42-52. doi: 10.1210/js.2017-00349. eCollection 2018 Jan 1.

Abstract

PURPOSE

To evaluate the relationship between eating patterns and therapeutic target's achieving in patients with type 2 diabetes.

METHODS

In this cross-sectional study, patients underwent clinical, laboratory, and nutritional evaluations. Dietary intake was assessed by a quantitative food frequency questionnaire and eating patterns identified by cluster analysis. The therapeutic targets were as follows: blood pressure, <140/90 mm Hg; BMI, <25 kg/m (<27 kg/m for elderly); waist circumference, <94 cm for men and <80 cm for women; fasting plasma glucose, <130 mg/dL; HbA1c, <7%; triglycerides, <150 mg/dL; HDL-cholesterol, >40 mg/dL for men and >50 mg/dL for women; LDL-cholesterol, <100 mg/dL.

RESULTS

One hundred ninety seven patients were studied. We identified two eating patterns: "unhealthy" (n = 100)-high consumption of refined carbohydrates, ultra-processed foods, sweets and desserts ( < 0.05); and "healthy" (n = 97)-high intake of whole carbohydrates, dairy, white meat, fish, fruits and vegetables ( < 0.05). The healthy group more frequently achieved therapeutic targets for fasting plasma glucose, HbA1c, and LDL-cholesterol than the unhealthy group. Poisson regression confirmed the association of healthy eating pattern with attaining the therapeutic target for fasting plasma glucose [PR, 1.59 (95% CI, 1.01 to 2.34); = 0.018], HbA1c [PR, 2.09 (95% CI, 1.17 to 3.74); = 0.013], and LDL-cholesterol [PR, 1.37 (95% CI, 1.01 to 1.86); = 0.042].

CONCLUSIONS

A healthy eating pattern, including the frequent intake of whole carbohydrates, dairy, white meat, fish, fruits, and vegetables, is associated with reduced fasting plasma glucose, HbA1c, and LDL cholesterol levels in patients with type 2 diabetes.

摘要

目的

评估2型糖尿病患者的饮食模式与治疗目标达成情况之间的关系。

方法

在这项横断面研究中,患者接受了临床、实验室和营养评估。通过定量食物频率问卷评估饮食摄入量,并通过聚类分析确定饮食模式。治疗目标如下:血压,<140/90 mmHg;体重指数,<25 kg/m²(老年人为<27 kg/m²);腰围,男性<94 cm,女性<80 cm;空腹血糖,<130 mg/dL;糖化血红蛋白,<7%;甘油三酯,<150 mg/dL;高密度脂蛋白胆固醇,男性>40 mg/dL,女性>50 mg/dL;低密度脂蛋白胆固醇,<100 mg/dL。

结果

对197名患者进行了研究。我们确定了两种饮食模式:“不健康”(n = 100)——精制碳水化合物、超加工食品、糖果和甜点的高摄入量(<0.05);以及“健康”(n = 97)——全谷物碳水化合物、乳制品、白肉、鱼类、水果和蔬菜的高摄入量(<0.05)。与不健康组相比,健康组更频繁地实现了空腹血糖、糖化血红蛋白和低密度脂蛋白胆固醇的治疗目标。泊松回归证实了健康饮食模式与实现空腹血糖治疗目标之间的关联[PR,1.59(95%CI,1.01至2.34);P = 0.018]、糖化血红蛋白[PR,2.09(95%CI,1.17至3.74);P = 0.013]以及低密度脂蛋白胆固醇[PR,1.37(95%CI,1.01至1.86);P = 0.042]。

结论

包括经常摄入全谷物碳水化合物、乳制品、白肉、鱼类、水果和蔬菜在内的健康饮食模式与2型糖尿病患者空腹血糖、糖化血红蛋白和低密度脂蛋白胆固醇水平降低有关。

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