摘要
目的:观察活性维生素D_(3)对老年肌少症合并糖尿病患者的干预效果。方法:收集2020年1—6月在我院收治的120例65~85岁的老年肌少症合并糖尿病的患者为研究对象。按照随机数字表随机分为观察组和对照组各60例,2组患者间性别、年龄、身高、体重、BMI无差异,具有可比性。两组患者均采用药物控制血糖,进行营养干预改善肌少症症状,观察组患者在此基础上给予口服骨化三醇,每次0.25μg,每天2次,连续服用48 w。于治疗前和治疗48 w后,收集患者清晨空腹静脉血,测定血清25(OH)D_(3)水平、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、空腹胰岛素水平(FINS),计算胰岛素抵抗指数(HOMA-IR);于干预前后测量骨骼肌肌量(ASM、ASM/H^(2))、优势手握力(HGS)及骨骼肌活动能力(SPPB),比较干预前后骨骼肌肌量、肌肉力量、骨骼肌活动能力、血糖变化及胰岛素抵抗状况。结果:2组患者治疗前,血清25(OH)D_(3)水平无差异[(13.85±2.51)vs(14.30±2.35)]mmol/L;治疗后,观察组患者血清25(OH)D_(3)水平显著增高,且高于对照组患者[(23.92±2.23)vs(14.73±2.12)]mmol/L(P<0.05);治疗前,2组患者ASM、ASM/H^(2)、HGS、SPPB均无差异;治疗后,观察组患者HGS和SPPB显著改善,均高于对照组指标(P<0.05)。治疗前,2组患者FBG、2 h PBG、HbA1c、HOMA-IR均无差异(P>0.05);治疗后,2组患者FBG、2 h PBG、HbA1c、HOMA-IR指标均显著下降,且观察组下降水平显著高于对照组患者(P<0.05)。结论:活性维生素D_(3)干预老年肌少症合并糖尿病患者48 w,能够显著提高血清维生素D水平,改善肌肉力量和骨骼肌活动能力,降低血糖水平,减轻胰岛素抵抗。
Objective To observe the effect of active vitamin D 3 on the intervention of elderly sarcopenia patients with diabetes.Method A total of 120 elderly patients with sarcopenia and diabetes mellitus aged 65 to 85 who were admitted to our hospital from February to August 2020 as the research objects.According to the random number table,they were randomly divided into observation group and control group with 60 cases each.There was no difference in gender,age,height,weight,and BMI between the two groups,and they were comparable.Both groups of patients used insulin to control blood sugar,and carried out health education to improve the symptoms of sarcopenia.On this basis,patients in the observation group were given oral calcitriol,0.25μg each time,twice a day for 48 weeks.Before treatment and after 48 weeks of treatment,the patient’s early morning fasting venous blood was collected to determine serum 25(OH)D 3 levels,fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c)and fasting insulin levels(FINS),calculate the homeostatic model assessment of insulin resistance(HOMA-IR).We measured skeletal muscle mass(ASM,ASM/H2),dominant hand grip strength(HGS)and skeletal muscle mobility(SPPB)before and after the intervention.The skeletal muscle mass,muscle strength,skeletal muscle activity,blood sugar changes and insulin resistance were compared before and after the intervention.Result Before treatment,there was no difference in serum 25(OH)D 3 levels between the two groups[(13.85±2.51)vs(14.30±2.35)]mmol/L.After treatment,serum 25(OH)D 3 levels in the observation group increased significantly and were higher than those in the control group[(23.92±2.23)vs(14.73±2.12)]mmol/L(P<0.05).Before treatment,there was no difference in ASM,ASM/H2,HGS,SPPB between the two groups of patients.After treatment,HGS and SPPB of the observation group were significantly improved,which were higher than those of the control group(P<0.05).Before treatment,there was no difference between the two group
作者
俞长君
姜铄
段俊婷
YU Chang-jun;JIANG Shuo;DUAN Jun-ting(Department of Nutrition,Civil Aviation General Hospital,Beijing 100123,China;Department of Endocrinology,Civil Aviation General Hospital,Beijing 100123,China)
出处
《中国食物与营养》
2022年第5期55-58,共4页
Food and Nutrition in China
