阿卡波糖和食物纤维在糖耐量减低人群向2型糖尿病发展中的干预作用

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目的:观察阿卡波糖和食物纤维预防糖耐量低减(IGT)人群进展为2型糖尿病(DM)的作用。方法:以口服75g葡萄糖耐量试验(OGTT)确诊(WHO标准)的IGT213例中男156例,女57例。入选者年龄35岁以上,体重指数(BMI)在19kg/m2以上。分为对照组52例,教育组37例,食物纤维组64例,阿卡波糖组60例。对照组进行一般的健康教育;教育组进行饮食指导,每半年1次;食物纤维组除健康教育外,每日口服食物纤维12g;阿卡波糖组每日口服阿卡波糖0.15g,分3次餐时口服。对4组参试者每半年作1次OGTT,同时测身高、体重、BMI、12h尿蛋白,复查日当天不服干预药物或食物纤维。共观察3年。若2次OGTT或最后1次复查结果为DM,则判断为已发展为DM。结果:213例IGT在观察中有18例(8.5%)退出。空腹血糖(FBS)和服糖后1h血糖(1hPBS)在对照组、教育组和食物纤维组均较治疗前略有升高,但在阿卡波糖治疗组均有下降。4组间FBS比较F=8.126,P<0.01,4组间1hPBS比较F=3.706,P=0.012。观察期末对照组12例(26.7%)、教育组7例(21.9%)、食物纤维组10例(16.4%)、阿卡波糖组5例(8.8%)转化为DM,阿卡波糖组在治疗后DM转化率明显低于对照组(χ2=6.246,P<0.05),其余各组间比较差异无显著性意义。单因素分析显示IGT向DM的转化率与治疗前年龄、体重呈正相关(r=0.45和0.35,P<0.05),与干预方式呈负相关(r=-0.155,P=0.01)。多元回归分析显示IGI向DM的转化率与FBS呈显著正相关(r=0.227,P=0.03),与治疗方式呈负相关(r=-0.133,P=0.032)。结论:阿卡波糖在延缓IGT向2型DM发展中是有效的,食物纤维可能有一定的作用。 Objective: To observe the role of acarbose and dietary fiber in preventing the progression of impaired glucose tolerance (IGT) to type 2 diabetes mellitus (DM). Methods: There were 156 male and 57 female IGT patients who were diagnosed by oral glucose tolerance test (OGTT) (WHO standard). Participants age 35 years of age or older, body mass index (BMI) 19kg / m2 or more. Divided into control group of 52 cases, 37 cases of education group, 64 cases of dietary fiber group, Acarbose group of 60 cases. Control group for general health education; education group diet guidance, once every six months; dietary fiber group in addition to health education, the daily oral dietary fiber 12g; acarbose group daily oral acarbose 0.15g, points 3 meals orally. OGTT was performed once every six months on the four groups of participants. Height, weight, BMI, and urine protein for 12 hours were also measured. On the day of review, they refused to accept the intervention drug or dietary fiber. A total of 3 years of observation. If the result of the second OGTT or the last review is DM, it is determined that DM has been developed. RESULTS: Eighteen (8.5%) of the 213 IGT patients were excluded from the observation. Fasting blood glucose (FBS) and 1h blood sugar (1hPBS) in the control group, education group and dietary fiber group were slightly higher than before treatment, but decreased in acarbose treatment group. FBS comparison between the four groups F = 8.126, P <0.01, 4h group 1hPBS comparison F = 3.706, P = 0.012. At the end of the observation period, 12 cases (26.7%) in control group, 7 cases (21.9%) in education group, 10 cases (16.4%) in dietary fiber group and 5 cases (8.8%) in acarbose group were converted into DM, acarbose group After treatment, the DM conversion rate was significantly lower than that of the control group (χ2 = 6.246, P <0.05), and the other groups showed no significant difference. Univariate analysis showed that the conversion rate of IGT to DM was positively correlated with the age and weight before treatment (r = 0.45 and 0.35, P <0.05), and negatively correlated with the intervention (r = -0.155, P = 0.01). Multivariate regression analysis showed that the conversion of IGI to DM was positively correlated with FBS (r = 0.227, P = 0.03) and negatively correlated with the treatment (r = -0.133, P = 0.032). CONCLUSION: Acarbose is effective in delaying the development of type 2 DM by IGT, and dietary fiber may play a role.
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