مجله دانشکده پزشکی اصفهان

مجله دانشکده پزشکی اصفهان

بررسی ارتباط چربی‌های رژیم غذایی با شاخص‌های سندرم متابولیک در بیماران مبتلا به دیابت نوع 2

نوع مقاله : مقاله های پژوهشی

نویسندگان
نفیسه سبحانی 1
محمد حسن انتظاری 2
آوات فیضی 3
غلامرضا عسگری 4
جمال رئیسی 5
1 دانشجوی کارشناسی ارشد، مرکز تحقیقات امنیت غذایی و گروه تغذیه‌ی بالینی، دانشکده‌ی تغذیه و علوم غذایی و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
2 استادیار، مرکز تحقیقات امنیت غذایی و گروه تغذیه‌ی بالینی، دانشکده‌ی تغذیه و علوم غذایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
3 دانشیار، گروه آمار و اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
4 استادیار، مرکز تحقیقات امنیت غذایی و گروه تغذیه‌ی جامعه، دانشکده‌ی تغذیه و علوم غذایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
5 فوریت‌های پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران
چکیده
قدمه: سندرم متابولیک، مجموعه‌ای از اختلالات متابولیک است که شیوع آن در بیماران مبتلا به دیابت در حال افزایش است. کیفیت چربی‌های رژیم غذایی بر روی شاخص‌های سندرم متابولیک اثر دارد. هدف از مطالعه‌ی حاضر، بررسی ارتباط اسیدهای چرب رژیم غذایی با شاخص‌های سندرم متابولیک در بیماران مبتلا به دیابت نوع 2 بود.روش‌ها: مطالعه‌ی حاضر، از نوع مطالعات مقطعی بود و بر روی 300 نفر از بیماران مبتلا به دیابت نوع 2 انجام شد. رژیم غذایی افراد شرکت کننده با پرسش‌نامه‌ی بسامد خوراک ارزیابی شد. تحلیل داده‌های غذایی با نرم‌افزار Nutritionist4 و محاسبات آماری با نرم‌افزار SPSS انجام شد.یافته‌ها: 6/69 درصد از بیماران، مبتلا به سندرم متابولیک بودند. بعد از تعدیل عوامل مخدوشگر، ارتباط معکوس معنی‌داری بین اسیدهای چرب امگا 3 با فشار خون سیستول (010/0 = P) و دیاستول (002/0 = P) مشاهده شد. همچنین، رابطه‌ی مستقیم معنی‌داری بین اسیدهای چرب با یک باند دوگانه با قند خون ناشتا (006/0 = P) و اسید چرب امگا 3 با تری‌گلیسیرید (010/0 = P) مشاهده شد.نتیجه‌گیری: بر اساس نتایج مطالعه، اسیدهای چرب امگا 3 با کاهش فشار خون افراد مبتلا به دیابت نوع 2، ارتباط دارند و همچنین ارتباط مستقیمی بین مصرف اسیدهای چرب با یک باند دوگانه با قند خون ناشتا و اسیدهای چرب امگا 3 با تری‌گلیسیرید مشاهده شد، اما برای تأیید نتایج، مطالعات آینده‌نگر بیشتری نیاز است.
کلیدواژه‌ها
اسیدهای چرب
رژیم غذایی
سندرم متابولیک
دیابت

عنوان مقاله English

Association of Dietary Fatty Acids with Metabolic Syndrome Indices in Patients with Type 2 Diabetes

نویسندگان English

Nafiseh Sbohani 1
Mohammad Hasan Entezari 2
Awat Feizi 3
Gholamreza Asgari 4
Jamal Reiesi 5
1 MSc Student. Food Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Sciences AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Food Security Research Center AND Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Department of Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
4 Assistant Professor, Food Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
5 Emergency Medical Service, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده English

Background: The metabolic syndrome includes several metabolic disorders and its incidence is increasing among diabetic patients. Types of dietary fats have been related to components of the metabolic syndrome. So this study aimed to investigate the association between dietary fatty acids with metabolic syndrome indices in patients with type 2 diabetes.Methods: This cross-sectional study was conducted on 300 patients with type 2 diabetes. Dietary intake was assessed using a validated Food Frequency Questionnaire. Nutritionist 4 Software was employed for analysis of dietary variables and SPSS software was used for statistical analysis.Findings: 69.6% 0f patients were diagnosed with metabolic syndrome. After adjustment of the confounder factors a significant negative correlation was observed between omega3 with systole blood pressure (P = 0.01) and diastole blood pressure (P = 0.002). Also significant positive correlation was observed between mono unsaturated fatty acids with fasting blood sugar (P = 0. 006) and omega3 with triglyceride (P = 0.01).Conclusion: According to the study, omega3 fatty acids are associated with a lower blood pressure in people with type 2 diabetes. Also, we observed positive correlation between mono unsaturated fatty acids with fasting blood sugar and omega3 with triglyceride. But, further prospective investigations are needed to confirm our results.

کلیدواژه‌ها English

Fatty acids
Diet
Metabolic Syndrome
Diabetes
  1. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106(25): 3143-421.
  2. Alexander CM, Landsman PB, Teutsch SM, Haffner SM. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003; 52(5): 1210-4.
  3. Kolovou GD, Anagnostopoulou KK, Salpea KD, Mikhailidis DP. The prevalence of metabolic syndrome in various populations. Am J Med Sci 2007; 333(6): 362-71.
  4. Zabetian A, Hadaegh F, Azizi F. Prevalence of metabolic syndrome in Iranian adult population, concordance between the IDF with the ATPIII and the WHO definitions. Diabetes Res Clin Pract 2007; 77(2): 251-7.
  5. Hadaegh F, Hasheminia M, Lotfaliany M, Mohebi R, Azizi F, Tohidi M. Incidence of metabolic syndrome over 9 years follow-up; the importance of sex differences in the role of insulin resistance and other risk factors. PLoS One 2013; 8(9): e76304.
  6. Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 1998; 21(4): 518-24.
  7. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27(5): 1047-53.
  8. Yadav D, Mahajan S, Subramanian SK, Bisen PS, Chung CH, Prasad GB. Prevalence of metabolic syndrome in type 2 diabetes mellitus using NCEP-ATPIII, IDF and WHO definition and its agreement in Gwalior Chambal region of Central India. Glob J Health Sci 2013; 5(6): 142-55.
  9. Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Targher G, et al. Prevalence of insulin resistance in metabolic disorders: the Bruneck Study. Diabetes 1998; 47(10): 1643-9.
  10. Maggio CA, Pi-Sunyer FX. The prevention and treatment of obesity. Application to type 2 diabetes. Diabetes Care 1997; 20(11): 1744-66.
  11. Carpentier YA, Portois L, Malaisse WJ. n-3 fatty acids and the metabolic syndrome. Am J Clin Nutr 2006; 83(6 Suppl): 1499S-504S.
  12. Kannel WB, McGee DL. Diabetes and cardiovascular risk factors: the Framingham study. Circulation 1979; 59(1): 8-13.
  13. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24(4): 683-9.
  14. Ghassemi H, Harrison G, Mohammad K. An accelerated nutrition transition in Iran. Public Health Nutr 2002; 5(1A): 149-55.
  15. Funaki M. Saturated fatty acids and insulin resistance. J Med Invest 2009; 56(3-4): 88-92.
  16. van Dijk SJ, Feskens EJ, Bos MB, Hoelen DW, Heijligenberg R, Bromhaar MG, et al. A saturated fatty acid-rich diet induces an obesity-linked proinflammatory gene expression profile in adipose tissue of subjects at risk of metabolic syndrome. Am J Clin Nutr 2009; 90(6): 1656-64.
  17. Melanson EL, Astrup A, Donahoo WT. The relationship between dietary fat and fatty acid intake and body weight, diabetes, and the metabolic syndrome. Ann Nutr Metab 2009; 55(1-3): 229-43.
  18. Riccardi G, Giacco R, Rivellese AA. Dietary fat, insulin sensitivity and the metabolic syndrome. Clin Nutr 2004; 23(4): 447-56.
  19. Mirmiran P, Hosseinpour-Niazi S, Naderi Z, Bahadoran Z, Sadeghi M, Azizi F. Association between interaction and ratio of omega-3 and omega-6 polyunsaturated fatty acid and the metabolic syndrome in adults. Nutrition 2012; 28(9): 856-63.
  20. Perez-Martinez P, Delgado-Lista J, Garcia-Rios A, Ferguson JF, Gulseth HL, Williams CM, et al. Calpain-10 interacts with plasma saturated fatty acid concentrations to influence insulin resistance in individuals with the metabolic syndrome. Am J Clin Nutr 2011; 93(5): 1136-41.
  21. Simopoulos AP. Dietary omega-3 fatty acid deficiency and high fructose intake in the development of metabolic syndrome, brain metabolic abnormalities, and non-alcoholic fatty liver disease. Nutrients 2013; 5(8): 2901-23.
  22. Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr 2010; 13(5): 654-62.
  23. Kelishadi R, Rabiei K, Khosravi A, Famouri F, Sadeghi M, Rouhafza H, et al. Assessment of physical activity of adolescents in Isfahan. J Shahrekord Uni Med Sci 2001; 3(2): 55-66. [In Persian].
  24. Kasim SE, Stern B, Khilnani S, McLin P, Baciorowski S, Jen KL. Effects of omega-3 fish oils on lipid metabolism, glycemic control, and blood pressure in type II diabetic patients. J Clin Endocrinol Metab 1988; 67(1): 1-5.
  25. Geleijnse JM, Giltay EJ, Grobbee DE, Donders AR, Kok FJ. Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. J Hypertens 2002; 20(8): 1493-9.
  26. Ebbesson SO, Risica PM, Ebbesson LO, Kennish JM, Tejero ME. Omega-3 fatty acids improve glucose tolerance and components of the metabolic syndrome in Alaskan Eskimos: the Alaska Siberia project. Int J Circumpolar Health 2005; 64(4): 396-408.
  27. Garg A. High-monounsaturated-fat diets for patients with diabetes mellitus: a meta-analysis. Am J Clin Nutr 1998; 67(3 Suppl): 577S-82S.
  28. Finucane OM, Lyons CL, Murphy AM, Reynolds CM, Klinger R, Healy NP, et al. Monounsaturated fatty acid-enriched high-fat diets impede adipose NLRP3 inflammasome-mediated IL-1beta secretion and insulin resistance despite obesity. Diabetes 2015; 64(6): 2116-28.
  29. Rocca AS, LaGreca J, Kalitsky J, Brubaker PL. Monounsaturated fatty acid diets improve glycemic tolerance through increased secretion of glucagon-like peptide-1. Endocrinology 2001; 142(3): 1148-55.
  30. Popp-Snijders C, Schouten JA, Heine RJ, van der Meer J, van der Veen EA. Dietary supplementation of omega-3 polyunsaturated fatty acids improves insulin sensitivity in non-insulin-dependent diabetes. Diabetes Res 1987; 4(3): 141-7.
  31. Goh YK, Jumpsen JA, Ryan EA, Clandinin MT. Effect of omega 3 fatty acid on plasma lipids, cholesterol and lipoprotein fatty acid content in NIDDM patients. Diabetologia 1997; 40(1): 45-52.
  32. Oh PC, Koh KK, Sakuma I, Lim S, Lee Y, Lee S, et al. Omega-3 fatty acid therapy dose-dependently and significantly decreased triglycerides and improved flow-mediated dilation, however, did not significantly improve insulin sensitivity in patients with hypertriglyceridemia. Int J Cardiol 2014; 176(3): 696-702.
  33. Kabir M, Skurnik G, Naour N, Pechtner V, Meugnier E, Rome S, et al. Treatment for 2 mo with n 3 polyunsaturated fatty acids reduces adiposity and some atherogenic factors but does not improve insulin sensitivity in women with type 2 diabetes: a randomized controlled study. Am J Clin Nutr 2007; 86(6): 1670-9.
  34. Hartweg J, Farmer AJ, Perera R, Holman RR, Neil HA. Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes. Diabetologia 2007; 50(8): 1593-602.
  35. Shin A, Lim SY, Sung J, Shin HR, Kim J. Dietary intake, eating habits, and metabolic syndrome in Korean men. J Am Diet Assoc 2009; 109(4): 633-40.
  36. Fessler MB, Rudel LL, Brown JM. Toll-like receptor signaling links dietary fatty acids to the metabolic syndrome. Curr Opin Lipidol 2009; 20(5): 379-85.
  37. Hekmatdoost A, Mirmiran P, Hosseini-Esfahani F, Azizi F. Dietary fatty acid composition and metabolic syndrome in Tehranian adults. Nutrition 2011; 27(10): 1002-7.
  38. Freire RD, Cardoso MA, Gimeno SG, Ferreira SR. Dietary fat is associated with metabolic syndrome in Japanese Brazilians. Diabetes Care 2005; 28(7): 1779-85.
  39. Tapsell LC, Batterham MJ, Teuss G, Tan SY, Dalton S, Quick CJ, et al. Long-term effects of increased dietary polyunsaturated fat from walnuts on metabolic parameters in type II diabetes. Eur J Clin Nutr 2009; 63(8): 1008-15.
مجله دانشکده پزشکی اصفهان
دوره 34، شماره 383 - شماره پیاپی 383
مرداد و شهریور 1395
صفحه 563-571

  • تاریخ دریافت 03 آذر 1394
  • تاریخ پذیرش 17 فروردین 1401