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目的:分析2型糖尿病(T2DM)合并非酒精性脂肪肝(nonalcoholic fatty liver,NAFLD)患者代谢及脂肪摄取特点,以期为正确指导该类患者科学合理饮食提供依据。方法:将238例住院糖尿病患者分为A组(T2DM伴NAFLD组118例)和B组(单纯T2DM组120例)。分析T2DM合并NAFLD与单纯T2DM患者的BMI、血压、肾功能、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、HOMA-IR、胰岛素、C肽等代谢特点;采用回顾法收集患者入院前3 d摄取的全部食物种类和数量,计算每组人均每天总能量、碳水化合物、蛋白质、脂肪、饱和脂肪酸、单不饱和脂肪酸和多不饱和脂肪酸摄入值,比较两组脂肪摄入情况。结果:A组患者的BMI、TG、TC、LDL-C、ALT、AST、HOMA-IR及基础胰岛素分泌值均明显高于B组(P<0.05);而HDL-C则低于B组(P<0.05)。A组总脂肪摄入量及占总能量比例明显高于B组(P<0.05);且A组饱和脂肪酸供能比高于B组(P<0.05),A组单不饱和脂肪酸低于B组(P<0.05)。结论:2型糖尿病患者饮食结构不合理,脂肪和饱和脂肪酸摄入偏高,单不饱和脂肪酸摄入偏少,合并NAFLD患者此现象更明显,具体机制需进一步研究,在糖尿病饮食指导工作中应该引起足够重视。
OBJECTIVE: To analyze the characteristics of metabolism and fat intake in patients with type 2 diabetes mellitus (T2DM) complicated with nonalcoholic fatty liver (NAFLD) so as to provide a basis for correctly guiding their scientific and rational diet. Methods: A total of 238 inpatients with diabetes were divided into group A (118 cases with T2DM and NAFLD) and group B (120 cases with T2DM alone). The levels of BMI, blood pressure, renal function, HbA1c, TG, TC, LDL-C, HDL-C in T2DM with NAFLD and T2DM alone were analyzed. Cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), HOMA-IR, insulin, C peptide and other metabolic characteristics; using retrospective method to collect patients before admission 3 d intake The total daily energy, carbohydrates, protein, fat, saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids intakes per group were calculated. The fat intake of the two groups was compared. Results: The BMI, TG, TC, LDL-C, ALT, AST, HOMA-IR and basal insulin secretion in group A were significantly higher than those in group B (P <0.05) P <0.05). The total fat intake and total energy in group A were significantly higher than those in group B (P <0.05). The energy supply ratio of saturated fatty acids in group A was higher than that in group B (P <0.05), and the percentage of monounsaturated fatty acids in group A was lower than that in group B Group (P <0.05). Conclusion: The diet of patients with type 2 diabetes is unreasonable, the intake of fat and saturated fatty acids is too high, and the intake of monounsaturated fatty acids is too low. This phenomenon is more obvious in patients with NAFLD. The specific mechanism needs to be further studied. In the course of diabetes diet guidance, Caused enough attention.