苯丙酮尿症青少年患者糖代谢状态及其与饮食的相关性

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摘要目的探讨苯丙酮尿症（PKU）青少年糖代谢状态与饮食控制的相关性。方法选取2016年9月～2019年3月在河北省承德市妇幼保健院（以下简称“我院”）定期复查的PKU患者96例，设为PKU组（苯丙氨酸浓度在240～600 μmol/L为控制良好组，苯丙氨酸浓度＞600 μmol/L为控制不良组），选取同期来我院行健康体检的同年龄健康青少年100名为对照组。分析饮食状况、苯丙氨酸（Phe）控制水平与胰岛素抵抗的相关性及影响PKU组糖尿病的危险因素。结果控制良好组（64例）每日碳水化合物摄入量、糖耐量异常发生率、空腹血糖、餐后2 h血糖水平、稳态模型胰岛素抵抗指数（HOMA-IR）高于控制不良组（32例），差异均有统计学意义（均P ＜ 0.05）；每日碳水化合物摄入量与HOMA-IR呈正相关，Phe控制水平与HOMA-IR呈负相关（均P ＜ 0.05）；每日碳水化合物摄入量高是导致青少年糖耐量异常及糖尿病的独立危险因素（OR = 1.048，P ＜ 0.05），Phe控制水平是保护因素（OR = 0.992，P ＜ 0.05）。结论 PKU青少年发生糖耐量异常和胰岛素抵抗的风险可能与摄入了更高的碳水化合物有关。

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	左雪梅金玉奇邱海南

关键词 ：苯丙酮尿症, 糖代谢, 苯丙氨酸, 饮食控制

Abstract：Objective To investigate the relationship between glucose metabolism and diet control in adolescents with phenylketonuria (PKU). Methods A total of 96 PKU patients for regular reexamination in Chengde Maternal and Child health Care Hospital (“our hospital” for short) were selected from September 2016 to March 2019, and they were divided into PKU group (phenylalanine concentration in 240-600 μmol/L was good control group, and phenylalanine concentration ＞600 μmol/L was poorly control group), 100 healthy adolescents of the same age who came to our hospital for physical examination in the same period were selected as the control group. The relationship between dietary status, Phe control level and insulin resistance and the risk factors of diabetes mellitus in PKU group were analyzed. Results The daily carbohydrate intake, incidence of abnormal glucose tolerance, fasting glucose, blood glucose level at 2 h after meal and homeostasis insulin resistance index (HOMA-IR) in the well-controll group (64 cases) were higher than those in the poorly controll group (32 cases), with statistically significant differences (all P ＜ 0.05). Daily carbohydrate intake was positively correlated with HOMA-IR, while Phe control level was negatively correlated with HOMA-IR (all P ＜ 0.05). High daily carbohydrate intake was an independent risk factor for abnormal glucose tolerance and diabetes in adolescents (OR = 1.048, P ＜ 0.05), and Phe control level was a protective factor (OR = 0.992, P ＜ 0.05). Conclusion The risk of abnormal glucose tolerance and insulin resistance in adolescents with PKU may be associated with higher carbohydrate intake.

Key words： Phenylketonuria Glucose metabolism Phenylalanine Diet control

基金资助:河北省医学科学研究重点课题计划项目（20181 504）。

引用本文:

左雪梅金玉奇邱海南. 苯丙酮尿症青少年患者糖代谢状态及其与饮食的相关性[J]. 中国医药导报, 2020, 17(8): 156-159.
ZUO Xuemei JIN yuqi QIU Hainan. Glucose metabolism status and the correlation with diet in adolescents with phenylketonuria. 中国医药导报, 2020, 17(8): 156-159.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I8/156

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