[The effect of nutrition intervention on the body composition and blood glucose in newly diagnosed patients with type 2 diabetes mellitus complicated with overweight and obesity].

Objective: To study the effect of nutrition intervention on the body composition and blood glucose in newly diagnosed patients with type 2 diabetes mellitus complicated with overweight and obesity. Methods: A total of 84 newly diagnosed patients with type 2 diabetes mellitus complicated with overweight and obesity were selected from the department of endocrinology in China-Japan Friendship Hospital from April 2015 to December 2016. Basic information and body composition of these patients were collected and measured. Also the food frequency questionnaire (FFQ) was used to investigate the dietary status in the past month, and calculate the intake of energy, three major nutrients and dietary fiber. All patients received nutrition intervention by nutritionist for three months as requested by Diabetes guidelines. After 3-month intervention, blood glucose, body composition and dietary status were examined again. Relevant indicators of patients were compared before and after the intervention. All patients were divided into three groups according to the degree of body mass index (BMI)'s change: <5%, 5%-10% and >10%. The differences of body weight, muscle, body fat rate, visceral fat index and blood glucose level among three groups were quantified. Results: There were 53 male patients with age (41.5±8.9) years and HbA1c (7.5±0.4)%, and 31 female patients with age (40.1±8.5) years with HbA1c (7.6±0.5)%. The intake of energy, carbohydrate and fat of patients were significantly decreased (P<0.05) and dietary fiber was significantly increased (P<0.05) after nutrition intervention. The body weight, muscle mass, fat mass and visceral fat index were also significantly decreased (P<0.05). The average decrease of fat was about 2.8 kg accounting for 73.7% (2.8 kg/3.8 kg) of the total weight loss. The body fat rate decreased from (31.2±3.1)% to (28.8±3.2)% (P<0.05). The fasting blood glucose and postprandial blood glucose were both decreased significantly after intervention (P<0.05). Among three BMI decreased groups, there was no significant difference in body weight and muscle mass (P>0.05), but a significant difference in body fat rate and visceral fat index (P<0.05). The body fat rate, visceral fat index, fasting blood glucose and postprandial blood glucose had more decreases with the greater amount of weight loss (P<0.05). Conclusion: The three-month nutrition intervention could change the dietary habit and components of patients with type 2 diabetes mellitus by reducing the blood glucose, body fat rate and visceral fat index significantly. The degree of reduced BMI is positively related to the decrease of fasting blood glucose and postprandial blood glucose.目的： 探讨营养干预对初诊2型糖尿病超重肥胖患者的身体成分和血糖的作用。 方法： 选取中日友好医院内分泌科2015年4月至2016年12月的首次诊断为2型糖尿病合并超重肥胖的门诊患者，共84例。收集患者基本资料并进行体成分测定，采用膳食频率法调查过去1个月的膳食情况，统计能量、三大营养素和膳食纤维的摄入量。按照糖尿病防治指南的要求，所有患者均在营养师的指导下进行营养干预，持续3个月后门诊复诊，复查血糖、人体成分测定和膳食频率调查。进行干预前后相关指标差异比较；将营养干预3个月后BMI减轻的程度分为3组：<5%、5%~10%、>10%组，比较干预后3组间体重、肌肉、体脂率、内脏脂肪指数和血糖水平的差异。 结果： 84例调查对象中男性53例，年龄为（41.5±8.9）岁，糖化血红蛋白为（7.5±0.4）%；女性31例，年龄为（40.1±8.5）岁，糖化血红蛋白为（7.6±0.5）%。营养干预后患者的能量、碳水化合物和脂肪摄入均有明显的减少（P<0.05），膳食纤维摄入明显提高（P<0.05）。患者体重、肌肉、脂肪量、内脏脂肪指数均明显下降（P<0.05），其中脂肪量平均下降达2.8 kg，占总体重变化的73.7%（2.8 kg/3.8 kg）；体脂率由（31.2±3.1）%降至（28.8±3.2）%（P<0.05）。干预后空腹血糖和餐后血糖均降低（P<0.05）。BMI减少<5%、5%~10%、和>10%组间体重和肌肉量的差异无统计学意义（P>0.05），但体脂率和内脏脂肪指数的组间差异有统计学意义（P<0.05），患者BMI减轻比例越大，体脂率、内脏脂肪指数、空腹血糖和餐后血糖越低（P<0.05）。 结论： 3个月的营养干预可改变2型糖尿病患者的饮食习惯及膳食成分，有利于其血糖、体脂率、内脏脂肪指数的降低，干预后BMI减轻幅度越大，空腹血糖、餐后血糖水平越低。.