fa بررسی اثر مصرف شکلات تلخ بر شاخص های گلیسمی و فشار خون در بیماران دیابتی نوع 2 مبتلا به پرفشاری خون:کارآزمایی بالینی تصادفی علوم تغذیه Nutrition Sciences پژوهشي Research <font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">زمینه و هدف</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">: شکلات و سایر فرآورده های غنی از فلاونوئید کاکائو، به علت خاصیت کاهندگی فشار خون، به عنوان یک درمان غیردارویی توجه زیادی را به خود جلب کرده اند. بنابراین این مطالعه با هدف تعیین اثرات 8 هفته مصرف شکلات تلخ بر قند خون ناشتا، هموگلوبین گلیکوزیله (</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">HbA1c</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>) و فشار خون بیماران دیابتی نوع 2 مبتلا به پرفشاری خون انجام شد.<o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">روش کار</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">: در این کارآزمایی بالینی 69 بیمار دیابتی مبتلا به فشار خون به طور تصادفی به دو گروهمداخله (35 نفر) و کنترل (34 نفر) تقسیم شدند. گروه مداخله روزانه 25 گرم شکلات تلخ (450 پلی فنول میلی گرم در روز) و گروه کنترل همان میزان شکلات سفید دریافت کردند. نمونه خون در ابتدا و بعد از 8 هفته مداخله جمع آوری گردید و سطوح قند خون ناشتا (</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">Fasting Blood Sugar-FBS</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>)، انسولین ناشتا و </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">HbA1c</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> خون اندازه گیری شدند. در ابتدا و انتهای مطالعه فشار خون سیستولی و دیاستولی، وضعیت آنتروپومتری،</span><span dir="ltr"></span><span lang="AR-SA" style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span> </span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">سطوح فعالیت بدنی، دریافت مواد غذایی نیز برآورد شد و بین دو گروه مقایسه گردید.</span><span lang="FA" style="font-family: "B Mitra" mso-bidi-language: FA mso-ascii-font-family: Calibri mso-hansi-font-family: Calibri"><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">یافته‌ها:</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 13pt mso-bidi-language: FA"> </span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">در گروه شکلات تلخ میزان فشار خون سیستول و دیاستول به طرز چشمگیری در مقایسه با گروه کنترل و ابتدای مطالعه کمتر بود (001/0</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">p<</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>)</span><span dir="ltr"></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span>.</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> سطوح قند خون ناشتا (</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">FBS</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>) (027/0=</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">p</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>) و </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">HbA1c</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> (025/0=</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">p</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>) نیز در گروه شکلات تلخ در مقایسه با ابتدای مطالعه کاهش یافتند.</span><span lang="FA" style="font-family: "B Mitra" font-size: 12pt mso-bidi-language: FA mso-ascii-font-family: Calibri mso-hansi-font-family: Calibri"><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">نتیجه</span></b><b><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-size: 10.0pt" dir="ltr">‌</span></b><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">گیری</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">: اطلاعات به دست آمده از این مطالعه پیشنهاد کننده این مطلب است که شکلات تلخ سبب بهبود فشارخون و کنترل گلیسمی در بیماران دیابتی مبتلا به فشار خون می شود.<o:p /></span></p><font face="Times New Roman" size="3"> </font> <font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">Background: </span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Chocolates and other cocoa products, as a none-pharmacologic treatment get attention due to their lowering blood pressure activity. The purpose of this study was to determine the effects of 8 weeks consumption of 25 gr dark chocolate (450 mg/day polyphenols) on glycemic control and blood pressure in hypertensive diabetic patients.</span><span style="font-size: 13pt mso-bidi-font-family: "B Mitra""><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: right 7.3pt center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Methods</span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">: This clinical trial was conducted on 69 hypertensive diabetic patients who were randomly assigned in two (intervention and control) groups. Groups (n=25) received 25 gr dark chocolate (450mg/day polyphenols) or similar amounts of White chocolate. Blood samples of patients were collected to measure Fasting Blood Glucose (FBS), fasting insulin and HbA1c level<span dir="rtl"></span><span lang="AR-SA" dir="rtl"><span dir="rtl"></span><font face="Times New Roman" size="3">.</font></span><span dir="ltr"></span><span dir="ltr"></span> Physical activity levels and nutrients intake were evaluated before and after intervention and were compared between the groups.<span lang="AR-SA" dir="rtl"><o:p /></span></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: right 7.3pt center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Results:</span></b><span style="font-size: 12pt mso-bidi-font-family: "B Mitra" mso-ascii-font-family: Calibri mso-hansi-font-family: Calibri"><font face="Calibri"> </font></span><span style="font-family: "Times New Roman","serif" font-size: 12pt">At the end of the study, intervention group had significantly lower systolic and diastolic blood pressure<span dir="rtl"></span><span dir="rtl"><span dir="rtl"></span><font face="Times New Roman" size="3"> </font></span><span dir="ltr"></span><span dir="ltr"></span>(p< 0.001) than control group.<span dir="rtl"></span><span dir="rtl"><span dir="rtl"></span><font face="Times New Roman" size="3"> </font></span>FBS, HbA1c, systolic and diastolic blood pressure declined significantly in intervention group during the trial.<o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: right 7.3pt center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Conclusions: </span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">These data suggest that polyphenols rich in dark chocolate may improve blood pressure and glycemic control in hypertensive diabetic patients.<span lang="AR-SA" dir="rtl"><o:p /></span></span></p><font face="Times New Roman" size="3"> </font> شکلات تلخ، وضعیت گلیسمی، فشار خون، دیابت نوع 2. Dark chocolate, Glycemic status, Blood pressure, Hypertensive diabetic patients. 78 86 http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1471&slc_lang=fa&sid=1 Neda Haghighat ندا حقیقت 3900319475328460024325 3900319475328460024325 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Ali Rostami علی رستمی 3900319475328460024326 3900319475328460024326 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Shahryar Eghtesadi شهریار اقتصادی 3900319475328460024327 3900319475328460024327 Yes Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Farzad Shidfar فرزاد شیدفر 3900319475328460024328 3900319475328460024328 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Iraj Heidari ایرج حیدری 3900319475328460024329 3900319475328460024329 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Aghafatemeh Hoseini آغا فاطمه حسینی 3900319475328460024330 3900319475328460024330 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران