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目的探讨膳食替代治疗联合生活方式干预对糖调节受损(impaired glucose regulation,IGR)患者的氧化应激水平和营养状况的影响。方法从社区招募IGR患者,随机分入干预组(n=46)和对照组(n=42)。采用随机对照临床试验,为期12个月,基线时两组受试者均接受健康教育和糖尿病防治宣教。此外,干预组还接受两阶段的综合干预,在干预第1～3月,受试者接受膳食替代干预和生活方式干预;干预第4～12月,每月随访一次,了解受试者的血糖和饮食变化情况。结果干预组受试者的体重减轻大于对照组[(-1.8±2.2)kg vs.(-0.6±2.5)kg,P<0.05],主要表现为体脂重量减少。干预前后两组受试者的LDL-C、空腹血糖、餐后2h血糖和HbA1c水平变化有显著性差异(P<0.05或P<0.01)。与基线水平相比,干预组受试者的SOD升高6.15 U/ml,而对照组降低16.71 U/ml(P<0.05)。干预前后各组之间膳食营养素摄入量的变化无显著改变(P>0.05)。但与基线水平相比,干预组受试者的钙、铁、维生素A和维生素B2的水平增高(P<0.05或P<0.01)。干预组有39.0%患者的血糖转归到正常水平,对照组的转归率仅有7.5%,两组的转归率有显著差异(P<0.01)。结论采用的膳食替代联合生活方式干预能改善IGR患者的体重、糖脂代谢和氧化应激水平,有效地提高IGR患者的膳食营养状况,有利于IGR患者的血糖转归到正常水平,因此膳食替代联合生活方式干预可作为促进糖调节受损转归的有效措施。
Objective To investigate the effects of dietary replacement therapy and lifestyle intervention on oxidative stress and nutritional status in patients with impaired glucose regulation (IGR). Methods IGR patients were enrolled from the community and were randomly assigned to intervention (n = 46) and control (n = 42). A randomized controlled clinical trial of 12 months was used. At baseline, both groups received education in health education and diabetes prevention and treatment. In addition, the intervention group also received a two-stage comprehensive intervention in the intervention from January to March, the subjects underwent dietary interventions and lifestyle interventions; intervention from December to December, monthly follow-up to understand the subject’s blood sugar And diet changes. Results The weight loss of the intervention group was significantly larger than that of the control group [(-1.8 ± 2.2) kg vs. (-0.6 ± 2.5) kg, P <0.05]. Before and after intervention, LDL-C, fasting blood glucose, 2h postprandial blood glucose and HbA1c levels were significantly different between the two groups (P <0.05 or P <0.01). Compared with baseline, SOD in subjects in the intervention group increased by 6.15 U / ml compared with 16.71 U / ml in the control group (P <0.05). There was no significant change in dietary nutrient intakes between groups before and after intervention (P> 0.05). However, subjects in the intervention group had elevated levels of calcium, iron, vitamin A and vitamin B2 compared with baseline (P <0.05 or P <0.01). In the intervention group, blood glucose was normalized in 39.0% of the patients in the intervention group, but only in the control group was 7.5%. There was a significant difference in the prognosis between the two groups (P <0.01). Conclusion Dietary intervention combined with lifestyle intervention can improve the body weight, glucose and lipid metabolism and oxidative stress in patients with IGR, improve the nutritional status of patients with IGR, and help the IGR patients return to normal levels of blood glucose, so meal replacement Joint lifestyle intervention can be used as an effective measure to promote the recovery of impaired glucose regulation.