摘要
目的探讨低碳水化合物饮食(LCD)与低脂饮食(LFD)干预对老年非酒精性脂肪肝(NAFLD)患者糖脂代谢水平与肝功能的影响。方法选取2018-07-01-2020-07-31河南省人民医院收治的82例老年NAFLD患者为研究对象,采用随机数值表法分为2组,各41例。一组给予LCD饮食(LCD组),另一组给予LFD饮食(LFD组),2组均持续干预6个月。于干预前、干预6个月后,检测2组血压〔舒张压(DBP)、收缩压(SBP)〕、体质量指数(BMI)、血糖〔空腹血糖(FPG)、糖化血红蛋白(HbA1c)〕、血脂〔三酰甘油(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)〕、肝功能〔谷丙转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)〕、肝脏脂肪沉积〔肝脏弹性测量值(LSM)、受控衰减参数(CAP)〕,采用独立样本t检验比较2组治疗后糖脂代谢与肝功能差异。结果干预6个月后,LFD组SBP、DBP水平分别为(130.55±10.85)、(83.45±5.48)mm Hg,LCD组分别为(131.14±10.54)、(84.46±5.19)mm Hg,差异无统计学意义,均P>0.05;LFD组FPG、HbA1c水平分别为(4.72±0.98)mmol/L、(4.84±0.51)%,LCD组分别为(4.85±1.02)mmol/L、(4.89±0.53)%,差异无统计学意义,均P>0.05;LFD组BMI为(27.27±2.18)kg/m^(2),高于LCD组的(26.31±2.04)kg/m^(2),t=2.058,P=0.043;LFD组TC、LDL-C、HDL-C水平分别为(4.41±0.57)、(2.42±0.55)、(1.08±0.24)mmol/L,LCD组分别为(4.31±0.56)、(2.54±0.58)、(1.06±0.25)mmol/L,差异无统计学意义,均P>0.05;LFD组TG水平为(1.63±0.43)mmol/L,高于LCD组的(1.41±0.38)mmol/L,t=2.455,P=0.016;LFD组ALT、AST、GGT水平分别为(42.95±13.72)、(35.49±9.38)、(35.71±10.36)U/L,LCD组分别为(40.86±12.25)、(34.67±9.43)、(34.92±10.84)U/L,差异无统计学意义,均P>0.05;LFD组LSM、CAP水平分别为(4.38±0.98)kPa、(252.57±18.34)dB/m,LCD组的分别为(4.31±0.95)kPa、(250.84±18.49)dB/m,差异无统计学意义,均P>0.05。结论LCD、LFD干预均有助于改善老年NAFLD患者的糖脂代谢及肝功能,且LCD更有助于BMI及TG的降低。
Objective To explore the effects of low-carbohydrate diet(LCD)and low-fat diet(LFD)on glucose-lipid metabolism indexes and liver function in elderly patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 82elderly patients with NAFLD admitted to Henan People’s Hospital between July 1,2018and July 31,2020were enrolled in the research.According to random number table method,they were divided into two groups with 41people in each group(LCD or LFD).Both groups were continuously intervened for 6months.Before and after 6months of intervention,blood pressure[diastolic blood pressure(DBP),systolic blood pressure(SBP)],body mass index(BMI),blood glucose[fasting plasma glucose(FPG),glycosylated hemoglobin A1c(HbA1c)],blood lipid[triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(GGT)]and iver fat deposition[liver stiffness measurement(LSM),controlled attenuation parameter(CAP)]were detected.The differences in glucose-lipid metabolism and liver function indexes between the two groups after treatment were compared by independent-samples T test.Results After 6months of intervention,levels of SBP and DBP in LFD group were(130.55±10.85),(83.45±5.48)mm Hg,without significant difference compared with those in LCD group[(131.14±10.54),(84.46±5.19)mm Hg](all P>0.05).The levels of FPG and HbA1cin LFD group were(4.72±0.98)mmol/L and(4.84±0.51)%,without significant difference compared with those in LCD group[(4.85±1.02)mmol/L,(4.89±0.53)%](all P>0.05).BMI in LFD group was higher than that in LCD group[(27.27±2.18)kg/m^(2)vs(26.31±2.04)kg/m^(2)](t=2.058,P=0.043).The levels of TC,LDL-C and HDL-C in LFD group were(4.41±0.57),(2.42±0.55)and(1.08±0.24)mmol/L,without significant difference compared with those in LCD group[(4.31±0.56),(2.54±0.58),(1.06±0.25)mmol/L](all P>0.05).TG level in LFD group was higher than that in LCD group[(1.63±0.43)mmol/Lvs(1.41±0.38)mmol/L](t=2.455,P=0.016).The levels of ALT,AST and GGT in LFD group were(42.95±13.72),(35.49±9.38)and(35.71±10.36)U/L,without significant difference compared with those in LCD group[(40.86±12.25),(34.67±9.43),(34.92±10.84)U/L](all P>0.05).The levels of LSM and CAP in LFD group were(4.38±0.98)kPa and(252.57±18.34)dB/m,without significant difference compared with those in LCD group[(4.31±0.95)kPa,(250.84±18.49)dB/m](all P>0.05).Conclusion Both LCD and LFD are beneficial to improve glucose-lipid metabolism indexes and liver function in elderly NAFLD patients.LCD is more conducive to reducing BMI and TG.
作者
雷雷
赵妍娟
高风双
蒋秋焕
LEI Lei;ZHAO Yan-juan;GAO Feng-shuang;JIANG Qiu-huan(Henan People's Hospital,Zhengzhou 450003,China)
出处
《社区医学杂志》
CAS
2022年第18期1051-1056,共6页
Journal Of Community Medicine
基金
河南省二O一七年科技发展计划(172102310600)
关键词
老年非酒精性脂肪肝
低碳水化合物饮食
低脂饮食
糖脂代谢
肝功能
elderly non-alcoholic fatty liver disease
low-carbohydrate diet
low-fat diet
glucose-lipid metabolism
liver function
作者简介
第一作者:雷雷,女,河南开封人,副主任护师,主要从事消化肿瘤营养护理相关的研究工作。E-mail:confidant1227@foxmail.com;通信作者:蒋秋焕,女,河南新密人,主任护师,主要从事老年护理和护理质量相关的研究工作。E-mail:qiuhuan1980@163.com
