بررسی اثر مصرف درشت مغذی‌ها بر ابتلا به پره‌دیابت در بستگان درجه‌ی اول مبتلایان به دیابت نوع 2

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه اپیدمیولوژی و آمار زیستی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استادیار، گروه اپیدمیولوژی و آمار زیستی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 مرکز تحقیقات غدد و متابولیسم، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 استاد، مرکز تحقیقات غدد و متابولیسم، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: مطالعات نشان داده‌اند که قبل از بروز دیابت نوع 2، همواره یک دوره پره‌دیابت روی می‌دهد. اصلاح شیوه‌ی زندگی به منظور پیشگیری یا به تأخیر انداختن این دوره پیشنهاد شده است. عملکرد تغذیه‌ای از اجزای شیوه‌ی زندگی است. مصرف درشت مغذی‌ها می‌تواند بر روی متابولیسم چربی و گلوکز تأثیر بگذارد و از این طریق، موجب تغییرات افزایش مقاومت به انسولین شود.روش‌ها: مطالعه‌ی حاضر یک مطالعه‌ی هم‌گروهی 9 ساله از بستگان درجه‌ی اول بیماران مبتلا به دیابت نوع 2 بود. اطلاعات تغذیه‌ای، عوامل خونی، شاخص‌های دموگرافیک و شاخص‌های آنتروپومتریک بیماران ثبت ‌شد. برای بررسی ارتباط بین مصرف درشت مغذی‌ها و متغیر پاسخ وضعیت پره‌دیابت، از مدل شکنندگی در بقا استفاده گردید.یافته‌ها: خطر تکرار پره‌دیابت در افراد با مصرف کربوهیدرات با حذف اثر سایر مخدوشگرها، به طور معنی‌داری افزایش می‌یابد (نسبت خطر = 04/1). همچنین خطر تکرار پره‌دیابت برای افرادی با چربی دریافتی بین 35-25 واحد، 52/1 بیشتر از افرادی با چربی دریافتی کمتر از 25 واحد بود و خطر برای افراد با چربی دریافتی بیش از 35 واحد، 22/2 بیشتر از افراد با چربی کمتر از 25 بود. خطر تکرار پره‌دیابت در افراد مصرف‌ کننده‌ی پروتئین نیز با تعدیل سایر متغیرهای مخدوشگر، به طور معنی‌داری افزایش یافت (نسبت خطر = 05/1).نتیجه‌گیری: مصرف درشت مغذی‌ها می‌تواند بر روی متابولیسم چربی و گلوکز تأثیر بگذارد و از این طریق، موجب تغییرات افزایش مقاومت به انسولین شود. مصرف این عامل، از عوامل تأثیرگذار در کنترل تکرار وضعیت پره‌دیابت می‌باشد. 

کلیدواژه‌ها

عنوان مقاله [English]

The Effects of Macronutrient Intake on the Risk of Pre-Diabetes in First-Degree Relatives of Patients with Type 2 Diabetes

نویسندگان [English]

  • Akram Yazdani 1
  • Marjan Mansourian 2
  • Elham Faghihimani 3
  • Maryam Zareh 3
  • Masoud Amini 4
1 MSc Student, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
3 Isfahan Endocrinology and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
4 Professor, Isfahan Endocrinology and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Previous studies showed that pre-diabetes often occurs prior to the incidence of type 2 diabetes. Accordingly, lifestyle modification has been suggested to prevent or delay the development of diabetes. The purpose of this study was to identify the impact of macronutrients consumption on recurrent events of pre-diabetes.Methods: This historical cohort study was performed for 9 years on first-degree relatives of patients with type 2 diabetes  attending to Isfahan endocrine and metabolism research center, Iran. The attendees completed laboratory tests including standard 75 g 2-hour current oral glucose tolerance test (OGTT). The outcome variables were the recurrence of a pre-diabetes event during follow-up and the assessed explanatory variables included protein, fat and carbohydrates intake, and a broad set of potential confounding variables were age categories, sex, overweight (body mas index or BMI), large waist-to-hip ratio (WHR), high-density lipoprotein (HDL), triglycerides, total cholesterol, high blood pressure, and low fiber intake. We considered the shared gamma frailty model to evaluate the association between recurrent pre-diabetes and explanatory variables. The R-software (version 2.15.2) was used to fit the models.Findings: Individuals with greater carbohydrate had a significantly higher hazard of recurrent pre-diabetes (hazard ratio = 1.04), adjusted by other variables. The hazards of recurrent pre-diabetes for individuals with fat intake of 25-35 unit were 1.52 higher than individuals with fat intake of lower than 25 unit; and for individuals with fat intake of more than 35 unit, hazards were 2.22 higher than individuals with fat intake of lower than 25 unit. Individuals with greater protein had a significantly higher hazard of recurrent pre-diabetes (hazard ratio = 1.05), adjusted by other variables.Conclusion: Macronutrient consumption can affect the metabolism of fat and glucose and cause changes in insulin resistance. The results of this study showed that macronutrients are effective in controlling diabetes. Further studies are recommended to achieve more accurate results. 

کلیدواژه‌ها [English]

  • Carbohydrate
  • Fat
  • Macronutrient
  • Pre-diabetes
  • Protein

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مجله دانشکده پزشکی اصفهان
دوره 32، شماره 301 - شماره پیاپی 301
مهر و آبان 1393
صفحه 1475-1486

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سابقه مقاله

  • تاریخ دریافت: 16 خرداد 1393
  • تاریخ بازنگری: 05 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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