未服用抗糖尿病药物的2型糖尿病患者饮食盐及其来源与糖化血红蛋白的关联：基于6个月适度低碳水化合物饮食干预的分析
Associations of Dietary Salt and Its Sources with Hemoglobin A1c in Patients with Type 2 Diabetes Not Taking Anti-Diabetic Medications: Analysis Based on 6-Month Intervention with a Moderate Low-Carbohydrate Diet.
作者信息
Haimoto Hajime, Murase Takashi, Watanabe Shiho, Maeda Keiko, Wakai Kenji
机构信息
Department of Internal Medicine, Haimoto Clinic, Kasugai City, Aichi, Japan.
Division of Endocrinology and Diabetes, Libra Sasashima Medical Clinic, Nagoya City, Aichi, Japan.
出版信息
Diabetes Metab Syndr Obes. 2021 Nov 19;14:4569-4578. doi: 10.2147/DMSO.S337032. eCollection 2021.
OBJECTIVE
Based on biological studies, the hyperglycemic effect mediated by sodium-glucose co-transporter 1 in the intestine is stronger for foods containing more sodium chloride. Observational studies have demonstrated that type 2 diabetes (T2DM) incidence increases as salt intake increases. We aimed to elucidate associations of total salt and its sources with hemoglobin A1c (HbA1c) in patients with T2DM.
METHODS
We conducted an observational study using data from a 6-month moderate low-carbohydrate dietary intervention in 245 outpatients with T2DM (138 men) without antidiabetic medication. Intakes of total salt and its sources, carbohydrate and total energy were assessed at baseline and 6 months based on 3-day dietary records. Multiple regression analyses were performed to examine associations of Δtotal salt or its sources with ΔHbA1c.
RESULTS
Salt intake significantly decreased in men (change: -0.92 ± 3.53 g/day) but not in women (0.11 ± 2.28). HbA1c (men: -1.5 ± 1.6%; women: -0.9 ± 1.3%), carbohydrate (men: -115 ± 104 g/day; women: -64 ± 71) and total energy (men: -439 ± 660 kcal/day; women: -192 ± 438) significantly decreased in both sexes. Multiple regression analysis revealed that reducing intakes of total salt and salt from salty snacks, meat processed foods, Chinese noodles with soup and table salt by 1.0 g was associated with decreases in HbA1c of 0.11% 1.18% 0.47% 0.38% and 0.26%, respectively, in men, while reducing salt from miso by 1.0 g was associated with a decrease in HbA1c of 0.30% in women. The associations were dependent on Δcarbohydrate or Δtotal energy in men, while the association of Δsalt from miso in women was independent of them.
CONCLUSION
Reducing total salt and its sources had differential associations with HbA1c. Individual associations depended on Δcarbohydrate or Δtotal energy in men, while that of salt from miso in women was independent of them.
目的
基于生物学研究，肠道中钠-葡萄糖协同转运蛋白1介导的高血糖效应对于含氯化钠较多的食物更强。观察性研究表明，2型糖尿病（T2DM）发病率随盐摄入量增加而上升。我们旨在阐明T2DM患者中总盐及其来源与糖化血红蛋白（HbA1c）之间的关联。
方法
我们进行了一项观察性研究，使用了245名未服用抗糖尿病药物的T2DM门诊患者（138名男性）为期6个月的适度低碳水化合物饮食干预的数据。根据3天饮食记录，在基线和6个月时评估总盐及其来源、碳水化合物和总能量的摄入量。进行多元回归分析以检验总盐或其来源的变化量（Δ）与HbA1c变化量之间的关联。
结果
男性的盐摄入量显著下降（变化量：-0.92±3.53克/天），但女性没有（0.11±2.28）。男女的HbA1c（男性：-1.5±1.6%；女性：-0.9±1.3%）、碳水化合物（男性：-115±104克/天；女性：-64±71）和总能量（男性：-439±660千卡/天；女性：-192±438）均显著下降。多元回归分析显示，男性将总盐以及咸味零食、肉类加工食品、汤面和食盐中的盐摄入量各减少1.0克，分别与HbA1c降低0.11%、1.18%、0.47%、0.38%和0.26%相关，而女性将味噌中的盐摄入量减少1.0克与HbA1c降低0.30%相关。男性的这些关联取决于碳水化合物变化量或总能量变化量，而女性味噌中盐变化量的关联与之无关。
结论
减少总盐及其来源与HbA1c的关联存在差异。男性的个体关联取决于碳水化合物变化量或总能量变化量，而女性味噌中盐的关联与之无关。
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