斋月间歇性禁食对2型糖尿病患者代谢和炎症指标的影响。
Impact of Ramadan intermittent fasting on metabolic and inflammatory profiles in type 2 diabetic patients.
作者信息
Oueslati Ibtissem, Kardi Asma, Boukhayatia Fatma, Hammami Bassem, Cheikh Meriem, Romdhane Neila Ben, Feki Moncef, Yazidi Meriem, Chihaoui Melika
机构信息
Department of Endocrinology, La Rabta University Hospital, Tunis, Tunisia.
Faculty of Medicine, University of Tunis El Manar, Rue JbelLakhdar, La RabtaJebbari 1007, Tunis, Tunisia.
出版信息
J Diabetes Metab Disord. 2022 May 7;21(1):751-758. doi: 10.1007/s40200-022-01046-8. eCollection 2022 Jun.
PURPOSE
The aim of this study was to assess the impact of Ramadan intermittent fasting on metabolic and inflammatory profiles in type 2 diabetic patients (T2D).
METHODS
It was a prospective study including 55 T2D patients treated with oral hypoglycemic drugs, who intended to observe Ramadan fasting in 2019. All participants underwent a questionnaire, a physical examination, laboratory investigations, and a cardiovascular risk assessment using the Framingham score before Ramadan (T0), immediately after Ramadan (T1), and two months after Ramadan (T2).
RESULTS
The mean age of participants was 54.5 ± 10.1 years. The number of fasted days was 29.3 ± 2.3 days. The mean total daily calorie intake decreased significantly by 19% during Ramadan ( < 10). A significant decrease in weight (79.8 ± 12.9 vs 78.4 ± 13.3 kg, = 0.003), body mass index (29.8 ± 5.4 vs 29.2 ± 5.4 kg/m, = 0.004), waist circumference (98.2 ± 9.6 vs 96.3 ± 10.2 cm, = 0.015), fat body mass (24.3 ± 9.4 vs 23.5 ± 9.7 kg, = 0.043) was observed at T1. The weight loss was significantly correlated with the number of fasting days (r = 0.348, = 0.009) and was maintained at T2. Serum fructosamine increased at T1 (303.6 ± 46 vs 333.49 ± 59.49 µmol/L, < 10) and returned to its baseline levels at T2. A significant decrease in insulin (9.7 ± 5.5 vs 7.98 ± 5.05 mIU/L = 0.043), fibrinogen (3.7 ± 0.8 vs 3.4 ± 0.6 g/L, = 0.003), and hs-CRP (4.8 ± 5.7 vs 3.7 ± 4.5 mg/L = 0.058) levels was observed at T1. Homocysteine level was significantly higher after Ramadan (12.2 ± 6.2 vs 13.5 ± 6.4 µmol/L, = 0.001). However, no significant changes were found in blood pressure, fasting blood glucose, HOMA-IR, uric acid, lipids, and white blood cells count. The mean Framingham score decreased insignificantly after Ramadan.
CONCLUSIONS
Ramadan fasting in T2D patients seems to have a favorable impact on anthropometric parameters and inflammatory profile. However, it may cause a transient worsening of glycemic control.
目的
本研究旨在评估斋月间歇性禁食对2型糖尿病患者（T2D）代谢和炎症指标的影响。
方法
这是一项前瞻性研究，纳入了55例接受口服降糖药治疗且打算在2019年进行斋月禁食的T2D患者。所有参与者在斋月前（T0）、斋月结束后即刻（T1）以及斋月结束后两个月（T2）均接受了问卷调查、体格检查、实验室检查以及使用弗明汉姆评分进行的心血管风险评估。
结果
参与者的平均年龄为54.5±10.1岁。禁食天数为29.3±2.3天。斋月期间平均每日总热量摄入显著减少19%（<0.01）。在T1时观察到体重（79.8±12.9 vs 78.4±13.3 kg，P = 0.003）、体重指数（29.8±5.4 vs 29.2±5.4 kg/m²，P = 0.004）、腰围（98.2±9.6 vs 96.3±10.2 cm，P = 0.015）、脂肪量（24.3±9.4 vs 23.5±9.7 kg，P = 0.043）显著下降。体重减轻与禁食天数显著相关（r = 0.348，P = 0.009），且在T2时维持该状态。血清果糖胺在T1时升高（303.6±46 vs 333.49±59.49 μmol/L，P<0.01），并在T2时恢复至基线水平。在T1时观察到胰岛素（9.7±5.5 vs 7.98±5.05 mIU/L，P = 0.043）、纤维蛋白原（3.7±0.8 vs 3.4±0.6 g/L，P = 0.003）和超敏C反应蛋白（4.8±5.7 vs 3.7±4.5 mg/L，P = 0.058）水平显著下降。斋月后同型半胱氨酸水平显著升高（12.2±6.2 vs 13.5±6.4 μmol/L，P = 0.001）。然而，血压、空腹血糖、HOMA-IR、尿酸、血脂和白细胞计数未发现显著变化。斋月后弗明汉姆评分平均无显著下降。
结论
T2D患者进行斋月禁食似乎对人体测量参数和炎症指标有有利影响。然而，它可能会导致血糖控制的短暂恶化。
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