Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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A Study on The Relation between Psychological Stress and Stress Hormone, Nutritional Status of Patients with Non-Insulim Dependent Diabetes Mellitus

인슐린 비의존형 당뇨병 환자의 심리적 스트레스와 스트레스호르몬 및 영양상태와의 상관관계에 관한 연구

  • 문수재 (연세대학교 생활과학대학 식품영양학과)
  • Published : 1996.10.01
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Abstract

This study estimated the re!ation between psychological stress and stress hormones, nu­t tritional status of patients with non-insulin dependent diabetes mellitus(NIDDM). Psycho­l logical stress such as depr'ession and anxiety in 34 diabetics was analyzedin relation to nutrient intake, blood components such as fasting blood sugar(FBS), hemoglobin AIC, stress hormones a and amino acids. The IeveIs of depression and anxiety were measured by The center for ep­i idemiological studies-depc$pm$111.49pg/ml for total catecholamine ( (norepmephrine and epinephrine) and 233.95 $pm$73.99pg/ml for norepinephrine, 94.03$pm$75. 9 97pg/ml for epinephrine, 13.lS$pm$5.55pl/dl for cortisol and 171.50$pm$62.50pg/ml for gul c cagon respectlveIy. The leveIs of stress hormones in diabetics such as total catecholamine, norep­i mephrine cortisol and glucagon were significantly higher than those in normal control. The lev­el of epmephrine was higher in diabetics but the diffierenee was not significant. The calorie m t take in diabetics was 1762$pm$292keal which is S1.4% lower than Korean recommended dietary a allowances(RDA). Calcium intake was slightly low but other nutrients intakeswere higher than R RDA. The value of fasting blood sugar(FBS), usual fasting blood sugar(usual FBS) which refteet a average FBS during 3 months and hemoglobin Al C in diabetics was 1S4.1S$pm$74.22mg/dl, 177.76$pm$42.77mg/dl and S.S4$pm$2.S2% respec디VeIy. The distribution of plasma amino acids in d diabetics was generally in the normal range. The leveI of anxiety in diabetics was positively cor­related with norepinephrine, concentration and usual FBS. The levels of glucagon, usual FBS a and hemoglobin Aj C were pOSI디veIy correlated with the branched chaimamino acid(BCM : leucme, isoleucme and valine)

인슐린 비의존형 당뇨병환자의 심리적 스트레스와 스트레스호르몬 및 영양상태와의 상과관계를 알아보고자 인슐린 비의존형 당뇨병환자 34명을 대상으로 설문지를 사용하여 직접면접을 통해 심리적 스트레스로 우울, 불안을 측정하였고 24시간 회상법에 의한 영양섭취상태, 에너지 소비량 등을 조사하였고, 공복시 혈액을 채취하여 일반혈액검사에 스트레스호르몬, 아미노산 등을 분석하였다. 우울과 불안은 CED-S와 STAI-S의 방법으로 측정하였고, 영양섭취상태는 전산분석하였다. 그리고 catecholamine, hemoglobin A1C와 아미노산은 HPLC로 분석하였으며 cortisol과 glucagon은 RIA방법으로 분석하였다. 본 연구의 결과, 당뇨병환자의 우울과 불안점수는 대조군에 비해 높았는데 특히 불안은 유의적으로 높았다. 당뇨병환자의 스트레스호르몬을 보면 총 catecholamine은 329.18$\pm$111.49pg/ml이었고 norepinephirne은 233.95$\pm$73.99pg/ml이었으며 epinephrine은 94.03$\pm$75.97pg/ml이었다. Cortisol은 13.18$\pm$5.55ul/ml이었으며 gulcagon은 171.50$\pm$62.50pg/ml이었다. 당뇨병환자의 총 catecholamine, norpinephrine, cortisol 그리고 glucagon 등은 대조군에 비해 유의적으로 높았으며 epinephrine은 높은 경향을 나타냈다. 당뇨병환자의 영양소섭취량은 대조군에 비해 차이가 없었다. 그러나 당뇨병환자의 경우 열량과 칼슘은 권장량보다 적었으나 다른 영양소들은 권장량보다 많이 섭취하였다. 공복혈당, 평상시 공복혈당 (3개월 평균 공복혈당) 그리고 hemoglobin A1C는 각각 184.18$\pm$74.22mg/dl, 177.76$\pm$42.77mg/dl와 8.84$\pm$2.82%이었다. 당뇨병환자의 혈장아미노산의 농도는 일반적으로 정상범위에 속하였다. 당뇨병환자의 불안은 norepinephrine과 평상시 공복혈당과 유의적인 양의 상관관계를 나타내었다. 또한 glucagon, 평상시 공복혈당과 hemoglobin A1C는 분지아미노산 (BCAA, leucine, isoleucine and valine)과 유의적인 양의 상관관계를 나타내었다.

Keywords

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