第2型糖尿病患者膳食纖維攝取量與血糖、血脂質及腎功能之相關性

The association of dietary fiber intakes with blood glucose, lipid profiles and renal function in type 2 diabetes patients

黃宇靖

第2型糖尿病 ； 膳食纖維攝取量 ； 血脂 ； 腎功能 ； type 2 diabetes ； dietary fiber intake ； lipid profiles ； renal function

中山醫學大學營養學系碩士班學位論文

2017年

碩士

黃詩茜

繁體中文

糖尿病為一種複雜病因組成的代謝疾病，若相關監控指標（肥胖、血糖、血脂、腎功能）未能控制得宜，易引發許多併發症。許多研究已證實補充膳食纖維可延緩糖尿病併發症發生，但一般飲食下，糖尿病患者能否攝取到足夠建議量，而以減緩併發症發生，則有待商榷。因此，本研究於彰化基督教醫院內分泌新陳代謝科門診募集693為第2型糖尿病患者，計算膳食纖維攝取量並經由熱量調整後，再依照三分位距分為三組。分別為膳食纖維攝取量最低組為5.34± 1.34 g/1000Kcal，次高組 8.68± 1.03 g/1000Kcal，最高組為 14.18 ± 4.27 g/1000Kcal，皆遠低於美國糖尿病協會之建議。調整性別與年齡、糖尿病罹病年、每日攝取總熱量、飲酒及抽菸習慣後，發現隨著膳食纖維攝取量增加，可顯著降低收縮壓（β = -1.81, p < 0.05）、腰臀比（β = -0.01, p < 0.00）與肌酸酐（β = -0.09, p < 0.05）；並且可顯著增加高密度脂蛋白膽固醇（β = 1.05, p= 0.05）與腎絲球過濾率（β = 4.41, p < 0.05）。本研究第2型糖尿病患者膳食纖維攝取量雖嚴重不足，但仍可發現膳食纖維攝取量攝取較多者，可降低患者血壓與腰臀比且能改善高密度脂蛋白膽固醇及腎功能。

Diabetes Mellitus is a metabolic disease combined several complicated disease factors. It caused varieties of complications if we don’t control the related indicators such as obesity, blood sugar, lipid profiles, renal function. Previous studies were approved dietary fiber can slow down the diabetic complications. However, it’s doubt that diabetic patients can eat enough dietary fiber from regular meal. Therefore, this study recruited 693 type 2 diabetic patients in the metabolic out-clinic of Changhua Christian Hospital. After collecting the dietary fiber intake which adjusted by total calorie intake, and dividing to three groups according to the dietary fiber intake. The average dietary fiber intake within three groups are 5.34 ± 1.34 g/1000 Kcal, 8.68 ± 1.03 g/1000 Kcal, and 14.18 ± 4.27 g/1000 Kcal. The average dietary fiber intakes in the three groups were all lower than the recommendation of American Diabetes Association. After adjusting gender, age, DM duration, energy intake per day, drinking and smoking, the result showed the higher dietary fiber intake, the lower systolic blood pressure (β = -1.81, p < 0.05), waist-and-hip ratio (β = -0.01, p < 0.00) and creatinine (β = -0.09, p < 0.05), and significant increase high-density lipoprotein (β = 1.05, p = 0.05) and glomerular filtration rate (β = 4.41, p < 0.05). This study showed the dietary fiber intake was not enough in the type 2 diabetic patients. But, we still can see the trend of more dietary intake and lower blood pressure, waist-and-hip ratio, high-density lipoprotein and better kidney function.

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