·糖尿病临床研究·

　　作者单位：300170天津医科大学三中心临床学院(郝春满、韩明明);天津市第三中心医院营养科(齐玉梅、陈亚军、张葳、王广义)

　　通讯作者：齐玉梅， E-mail：qym0305@yahoo.com.cn

　　住院2型糖尿病患者能量供给量及供能系数的探讨

　　郝春满 齐玉梅 韩明明 陈亚军 张葳 王广义

　　【摘要】目的探讨住院T2DM患者能量供给量与静息能量消耗(REE)的关系，为临床营养治疗确立适宜能量供给量提供参考依据。方法选择内分泌科T2DM患者97例，根据BMI水平分为体重正常组(A组)、超重组(B组)和肥胖组(C组)。入院后即采用通用系数法为患者确立能量供给量，并通过能量调整使患者的空腹及3餐后2 hPG水平稳定。用代谢车测定患者REE，比较3组患者能量供给量与REE的关系，并由此研究出供能系数。结果3组患者治疗后空腹、3餐后2 hPG较治疗前均降低(P<0.05)，并基本达到血糖控制目标;A组患者能量供给量与消耗量基本达到平衡，B组和C组患者能量供给量低于消耗量;REE随BMI水平升高而升高;A、B和C组患者供能系数分别为1.02、0.93和0.85(P<0.05)，供能系数随BMI水平升高而降低。结论住院T2DM患者REE随BMI水平升高而升高，其能量供给量依据REE进行确立时，应考虑不同BMI水平及其相对应的供能系数。

　　【关键词】糖尿病，2型;能量传递;能量代谢;体质指数

　　doi:10.3969/j.issn.1006-6187.2012.05.016

　　Study on the energy supply and energy coefficient in hospitalized patients with type 2 diabetesHAO Chun-man, QI Yu-mei, HAN Ming-ming, et al. Department of Nutrition, Tianjin Third Central Hospital, Tianjin 300170, China

　　Corresponding author: QI Yu-mei, E-mail: qym0305@yahoo.com.cn

　　【Abstract】ObjectiveTo investigate the relationship between energy supply and resting energy expenditure (REE) of hospitalized patients with type 2 diabetes.MethodsNinety-seven hospitalized T2DM patients in endocrinology department were divided into three groups according to body mass index, normal weight group (A), overweight group (B), and obesity group (C). The energy supply was calculated by general coefficient method on admission, and was gradually adjusted to make the levels of fasting plasma glucose (FPG) and 2-hour postprandial glucose (2 hPG) stable. REE was measured by using the indirect calorimetry. The relationship between energy supply and REE was compared, then the energy coefficients of the three groups were calculated.ResultsFPG and 2 hPG of the three groups decreased statistically after treatment (P<0.05) , and they reached basically the expected target. The balance between energy supply and consumption is basically kept in group A, while the energy supply was less than consumption in group B and C. REE increased with the increase of BMI. The energy coefficients of the patients of three groups were 1.02, 0.93, and 0.85 respectively (P<0.05). The energy coefficient decreased with the increase of BMI.ConclusionREE increases with the increase of BMI in the hospitalized T2DM patients. The different levels of BMI and their corresponding energy coefficients should be taken into consideration when the energy requirement is determined according to REE.

　　【Key words】Diabetes mellitus, type 2; Energy transfer; Energy metabolism; Body mass index