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[目的]观察高蛋白膳食对肥胖型2型糖尿病患者的治疗作用。[方法]采用随机、对照研究,选择40例肥胖型2型糖尿病患者,体质指数(BMI)≥25kg/m2,随机分为高蛋白组及对照组,每组各20例。两组均予低热量饮食,低于每天平均摄入热量的(1045～2090)kJ,并维持原治疗方案。在此基础上高蛋白组每天蛋白质的摄入量大于总能量的20%,而对照组每天蛋白质的摄入量在10%～20%,治疗2个月。在治疗前后分别测空腹血糖(FBG)、体质指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS),用稳态模式胰岛素指数(HOMA-IR)评价胰岛素抵抗。[结果]治疗后,高蛋白组FBG、BMI、TC、TG、LDL、HbA1c、FINS、HOMA-IR与治疗前相比均有明显下降,差异均有统计学意义(P﹤0.05或P﹤0.01),HDL变化不明显;高蛋白组BMI、TC、TG、LDL、HbA1c、FINS、HOMA-IR改善的程度明显优于对照组,差异均有统计学意义(P﹤0.01),FBG和HDL改善的程度与对照组相比不明显。[结论]在低热量饮食的基础上,高蛋白膳食不仅可以显著降低肥胖型2型糖尿病患者的体质量,而且可以改善其代谢控制状况及胰岛素敏感性,耐受性好。
[Objective] To observe the therapeutic effect of high-protein diet on obese type 2 diabetic patients. [Methods] Forty obese patients with type 2 diabetes mellitus (T2DM) with body mass index (BMI) ≥25 kg / m2 were randomly divided into high protein group and control group, with 20 cases in each group. Both groups were given low-calorie diet, less than the average daily intake of calories (1045 ~ 2090) kJ, and maintain the original treatment. On this basis, protein intake of high protein group was more than 20% of total energy per day, while protein intake of control group was 10% -20% daily for 2 months. FBG, BMI, TC, TG, HDL, LDL, HbA1c were measured before and after treatment. ), Fasting insulin (FINS) and insulin resistance using homeostasis model insulin index (HOMA-IR). [Results] After treatment, FBG, BMI, TC, TG, LDL, HbA1c, FINS and HOMA-IR in high protein group were significantly decreased compared with before treatment, the differences were statistically significant (P <0.05 or P <0.01 ), HDL did not change significantly. The levels of BMI, TC, TG, LDL, HbA1c, FINS and HOMA-IR in the high protein group were significantly better than those in the control group (P <0.01) The degree of comparison with the control group is not obvious. [Conclusion] On the basis of low calorie diet, high protein diet can not only significantly reduce the body weight of obese type 2 diabetic patients, but also improve the metabolic control status and insulin sensitivity, which is well tolerated.