Objective To explore the effects of chromium and magnesium supplementation on glucose and lipid metabolism and insulin resistance in impaired glucose regulation people.Methods A total of 180 subjects with impaired glucose regulation from February 2013 to February 2015 were randomly divided into control group,magnesium group and chromium-magnesium group (60 cases in each group).All the patients were orally given vitamin C 400 mg/d,vitamin E 160 mg/d and calcium tablet 500 mg/d;magnesium group was additionally given magnesium 200 mg/d,and chromium-magnesium group was additionally given magnesium 200 mg/d and chromium 160 μg/d;the treatment lasted for 12 weeks.The body mass index,waist to hip ratio,fasting blood glucose (FBG),postprandial 2 h glucose (2 h PG),fasting insulin (FINS),homeostasis model assessment of insulin resistance index (HOMA-IR),total cholesterol,triglyceride,low density lipid protein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) before and after treatment were compared among groups.The hypoglycemia event and adverse drug reactions were recorded.Results A total of 168 subjects completed 12 weeks of treatment,including 55 cases in control group,57 cases in magnesium group and 56 cases in chromium-magnesium group;7 subjects were lost to follow-up and 5 cases were not completed the trail.After 12 weeks of treatment,the levels of FBG and FINS in magnesium group and chromium-magnesium group were significantly lower than those in control group [FBG:(5.33 ± 0.63),(5.02 ± 0.14) mmol/L vs (6.38 ± 1.17) mmol/L;FINS:(11 ± 6),(9 ± 5) mU/L vs (12 ± 6) mU/L] (P ＜ 0.05);the 2 h PG after treatment in chromium-magnesium group was significantly lower than that before treatment [(7.5 ± 2.6) mmol/L vs (9.5 ± 1.0) mmol/L] (P ＜ 0.01);after treatment,the HOMA-IR in magnesium group and chromium-magnesium group,especially in chromium-magnesium group,was significantly lower than that in control group [(2.5 ± 1.3),(2.1 ±1.2) vs (2.8 ±2.3)] (P ＜0.05);after treatment,the 2 h PG and waist to hip ratio in chromium-magnesium group were significantly lower than those in control group [(7.5 ± 2.6) mmol/L vs (9.0 ±1.8) mmol/L,(0.84 ± 0.06) mmol/L vs (0.90 ± 0.07) mmol/L] (P ＜ 0.05).The body mass index,total cholesterol and LDL-C were not significantly changed after treatment in all the groups (P ＞ 0.05);in chromium-magnesium group,the triglyceride was significantly lower after treatment than that before treatment,the HDL-C was significantly higher after treatment than that before treatment and that in control group [triglyceride:(1.1 ±0.5) mmol/L vs (2.1±0.8) mmol/L;HDL-C:(1.7±0.5) mmol/L vs (1.2±0.4),(1.4±0.3) mmol/L](P ＜ 0.05).Conclusion Chromium and magnesium supplementation can improve the glycaemic and lipid metabolism,insulin resistance in impaired glucose tolerance people,and the safety is good.%目的 探讨铬镁联合补充对糖调节受损人群糖脂代谢及胰岛素抵抗的影响.方法 选取2013年2月至2015年2月山东省青岛市中心医院就诊及查体的糖调节受损但非糖尿病者180例为研究对象.采用随机数字表法分为对照组、镁离子组、铬镁联合补充组,各60例.对照组服用维生素C400 mg/d、维生素E 160 mg/d、钙片500 mg/d;镁离子组在对照组基础上加用镁200 mg/d;铬镁联合补充组在镁离子组基础上加用铬160 μg/d;均治疗12周.比较治疗前后受试者体重指数、腰臀比、空腹血糖、餐后2h血糖(2 h PG)、空腹胰岛素(FINS)水平、稳态模型胰岛素抵抗指数(HOMA-IR)、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等指标变化情况,同时记录低血糖事件及药物不良反应.结果 180例受试者中共有168例完成12周的治疗,其中对照组55例,镁离子组57例,铬镁联合补充组56例;共失访7例;未完成试验5例.治疗12周后,镁离子组及铬镁联合补充组空腹血糖及空腹胰岛素水平均较对照组低,差异均有统计学意义[空腹血糖:(5.33±0.63)、(5.02 ±0.14) mmol/L比(6.38±1.17) mmol/L,FINS:(11 ±6)、(9±5) mU/L比(12±6) mU/L,均P＜0.05].铬镁联合补充组2 hPG较治疗前下降,差异有统计学意义[(7.5±2.6) mmol/L比(9.5±1.0)mmol/L,P ＜0.01].镁离子组及铬镁联合补充组HOMA-IR均较对照组低,差异均有统计学意义[(2.5±1.3)、(2.1±1.2)比(2.8±2.3),均P＜0.05],其中铬镁联合补充组下降更明显.铬镁联合补充组2 hPG、腰臀比均低于对照组,差异均有统计学意义[(7.5±2.6) mmol/L比(9.0±1.8) mmol/L,(0.84 ±0.06) mmol/L比(0.90±0.07) mmol/L,均P＜0.05].各组体重指数、总胆固醇、LDL-C均较治疗前降低,但差异无统计学意义(P＞0.05).铬镁联合补充组三酰甘油较治疗前降低,HDL-C较治疗前升高且高于对照组,差异均有统计学意义[三酰甘油:(1.1 ±0.5)mmol/L比(2.1 ±0.8)mmol/L,HDL-C:(1.7±0.5)mmol/L比(1.2±0.4)、(1.4±0.3) mmol/L,均P＜0.05].结论 铬镁联合补充可以明显改善糖调节受损人群的糖脂代谢,改善胰岛素抵抗,具有良好的安全性.
展开▼
