Department of Life and Environmental Science, Kagoshima Prefectural College, Kagoshima, Japan;
Department of Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
In Vivo. 2024 Sep-Oct;38(5):2506-2514. doi: 10.21873/invivo.13722.
BACKGROUND/AIM: Although nutritional risk factors for developing complications in type 2 diabetes mellitus (T2DM) have been examined, the effect of protein intake on nephropathy is debated, and there is little research on retinopathy. This cross-sectional case-series study aimed to examine the risk factors, including nutritional status, for complications in patients newly diagnosed with T2DM.
Fifty-four patients were recruited, based on the results of examinations of blood glucose and/or glycated hemoglobin level for T2DM. To evaluate nutritional status, blood and urine examinations were performed and the Food Frequency Questionnaire was administered. Two-way analysis of variance, Fisher's exact test and logistic regression analyses were performed.
The patients were categorized into four groups: 24 without albuminuria and without retinopathy, four without albuminuria with retinopathy, 21 with albuminuria without retinopathy, and five with albuminuria with retinopathy. Logistic analysis of albuminuria revealed that estimated sodium intake was significantly independent as the explanatory factors of age, sex, and body mass index. Patients with retinopathy had significantly higher blood urea nitrogen, and significantly lower plasma total protein levels than patients without retinopathy, suggesting that retinopathy is related to a higher catabolic state. Through a questionnaire on food intake, patients with retinopathy had a significantly lower intake of fat and monounsaturated fatty acids and a significantly higher intake of iodine based on intake of seaweed, corrected for energy intake, than patients without retinopathy.
The present study may lead to planning a large cohort study for examining nutritional risk factors related to complications in patients newly diagnosed with T2DM in Japan.
背景/目的：虽然已经研究了 2 型糖尿病（T2DM）并发症发生的营养风险因素，但关于蛋白质摄入对肾病的影响仍存在争议，且关于视网膜病变的研究较少。本横断面病例系列研究旨在检查新诊断为 T2DM 的患者的并发症相关的风险因素，包括营养状况。
根据血糖和/或糖化血红蛋白检查结果，招募了 54 例 T2DM 患者。为了评估营养状况，进行了血液和尿液检查，并进行了食物频率问卷调查。进行了双因素方差分析、Fisher 确切检验和逻辑回归分析。
患者被分为四组：24 例无白蛋白尿且无视网膜病变、4 例无白蛋白尿但有视网膜病变、21 例有白蛋白尿但无视网膜病变和 5 例有白蛋白尿和视网膜病变。白蛋白尿的逻辑分析显示，估计钠摄入量是年龄、性别和体重指数的独立解释因素。有视网膜病变的患者的血尿素氮显著升高，血浆总蛋白水平显著降低，表明视网膜病变与更高的分解代谢状态有关。通过食物摄入问卷，与无视网膜病变的患者相比，有视网膜病变的患者的脂肪和单不饱和脂肪酸摄入量明显较低，而基于海藻摄入量校正的碘摄入量明显较高，校正能量摄入后。
本研究可能会促成在日本计划一项新的队列研究，以检查新诊断为 T2DM 的患者的并发症相关的营养风险因素。
