富含缓释淀粉高单不饱和脂肪酸型肠内营养制剂对糖耐量异常患者糖脂代谢的影响

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摘要目的：观察富含缓释淀粉高单不饱和脂肪酸（MUFA）肠内营养（EN）制剂对糖耐量异常（IGT）患者糖脂代谢的影响。方法：62例IGT患者随机分为试验餐组（n=32)和普通餐组（n=30）。试验餐组服用富含缓释淀粉高MUFA的EN制剂（雅培益力佳SR）替代早餐，普通餐组服用等热量的纯牛奶+淡馒头，所有患者分别于干预前和干预4周后检测空腹血糖（FPG）、餐后2 h血糖（PPG）、空腹胰岛素（FINS）、餐后2 h胰岛素（PINS）以及血脂系列，就各项指标进行组内前后比较和组间比较。结果：试验餐组干预4周后体质量以及PPG、PINS、血清甘油三脂（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-c）均低于干预前，差异有统计学意义（P＜0.05或P＜0.01）；干预后，试验餐组PPG、PINS、TG、TC和LDL-c均低于普通餐组，差异有统计学意义（P＜0.01或P＜0.05）。结论：富含缓释淀粉高MUFA的EN制剂有利于降低单纯IGT患者PPG和PINS水平，并改善脂质代谢。

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	吴文俊1
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关键词 ：缓释淀粉, 单不饱和脂肪酸, 糖耐量异常, 血脂, 血糖

Abstract：Objective: To investigate the effects of enteral nutrition containing slow-release starch and high-monounsaturated-fat on blood and lipid metabolism in patients with impaired glucose tolerance. Methods: Sixty-two patients with impaired glucose tolerance from out-patient clinic were randomized to experimental meal group (Abbott Glucerna SR, n=32) and common breakfast group (isocaloric normal oral diet, n=30), the fasting plasma glucose, 2-hour postprandial plasma glucose, fasting insulin, 2-hour postprandial insulin, serum lipid profile were examined before and after 4-week intervention, and the parameters were compared within groups and between groups. Results: The 2-hour postprandial plasma glucose, postprandial serum insulin, serum triglyceride, total cholesterol and low-density lipoprotein cholesterol significantly decreased in experimental meal group (P<0.05 or P<0.01), when compared with that of baseline; After 4-week intervention, these parameters were statistically lower than that in common breakfast group (P<0.01 or P<0.05). Conclusion: Dietary consumption of slow-release starch and high-monounsaturated fat can improve glucose metabolism and lipid control in patients with impaired glucose tolerance.

Key words： slow-release starch monounsaturated fatty acid impaired glucose tolerance lipids blood glucose

收稿日期: 2014-09-04

基金资助:国家自然科学基金青年项目（81000356）；温州市科技计划项目（Y20110186）。

通讯作者: 谷雪梅，副教授，Email：snowgxm@126.com。

作者简介: 吴文俊（1978-），男，浙江温州人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2015/V45/I1/6

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