Beretta Mileni Vanti, Bernaud Fernanda R, Nascimento Ciglea, Steemburgo Thais, Rodrigues Ticiana C
Divisão de Endocrinologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
Departamento de Nutrição, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
Arch Endocrinol Metab. 2018 Feb;62(1):47-54. doi: 10.20945/2359-3997000000008.
Objective The present investigation sought to evaluate the potential association between dietary fiber intake and blood pressure (BP) in adult patients with type 1 diabetes (T1D). Subjects and methods A cross-sectional study was carried out in 111 outpatients with T1D from Porto Alegre, Brazil. Patients were predominantly male (56%) and white (88%), with a mean age of 40 ± 10 years, diabetes duration of 18 ± 9 years, BMI 24.8 ± 3.85 kg/m2, and HbA1c 9.0 ± 2.0%. After clinical and laboratory evaluation, dietary intake was evaluated by 3-day weighed-diet records, whose reliability was confirmed by 24-h urinary nitrogen output. Patients were stratified into two groups according to adequacy of fiber intake in relation to American Diabetes Association (ADA) recommendations: below recommended daily intake (< 14g fiber/1000 kcal) or at/above recommended intake (≥ 14g/1000 kcal). Results Patients in the higher fiber intake group exhibited significantly lower systolic (SBP) (115.9 ± 12.2 vs 125.1 ± 25.0 mmHg, p = 0.016) and diastolic blood pressure (DBP) (72.9 ± 9.2 vs 78.5 ± 9.3 mmHg, p = 0.009), higher energy intake (2164.0 ± 626.0 vs 1632.8 ± 502.0 kcal, p < 0.001), and lower BMI (24.4 ± 3.5 vs 26.2 ± 4.8, p = 0.044). Linear regression modelling, adjusted for age, energy intake, sodium intake, and BMI, indicated that higher fiber intake was associated with lower SBP and DBP levels. No significant between-group differences were observed with regard to duration of diabetes, glycemic control, insulin dosage, or presence of hypertension, nephropathy, or retinopathy. Conclusion We conclude that fiber consumption meeting or exceeding current ADA recommendations is associated with lower SBP and DBP in patients with T1D.
目的 本研究旨在评估成年1型糖尿病(T1D)患者膳食纤维摄入量与血压(BP)之间的潜在关联。
受试者与方法 对来自巴西阿雷格里港的111例T1D门诊患者进行了一项横断面研究。患者以男性为主(56%),白人(88%),平均年龄40±10岁,糖尿病病程18±9年,体重指数(BMI)24.8±3.85kg/m²,糖化血红蛋白(HbA1c)9.0±2.0%。经过临床和实验室评估后,通过3天称重饮食记录评估饮食摄入量,其可靠性通过24小时尿氮排出量得到证实。根据膳食纤维摄入量相对于美国糖尿病协会(ADA)建议的充足程度,将患者分为两组:低于推荐每日摄入量(<14g纤维/1000千卡)或达到/高于推荐摄入量(≥14g/1000千卡)。
结果 膳食纤维摄入量较高组的患者收缩压(SBP)(115.9±12.2 vs 125.1±25.0mmHg,p = 0.016)和舒张压(DBP)(72.9±9.2 vs 78.5±9.3mmHg,p = 0.009)显著较低,能量摄入量较高(2164.0±626.0 vs 1632.8±502.0千卡,p<0.001),BMI较低(24.4±3.5 vs 26.2±4.8,p = 0.044)。经年龄、能量摄入量、钠摄入量和BMI校正的线性回归模型表明,较高的膳食纤维摄入量与较低的SBP和DBP水平相关。在糖尿病病程、血糖控制、胰岛素剂量或高血压、肾病或视网膜病变的存在方面,未观察到组间显著差异。
结论 我们得出结论,在T1D患者中,满足或超过当前ADA建议的膳食纤维摄入量与较低的SBP和DBP相关。