第31回管理栄養士国家試験問題 臨床栄養学

1 31 1 31 115 1 1 2 3 4 5 ( ) A1c HbA1c JDS NGSP ( ) ( ) 1 2 3 4 5 2 31 2 31 116 1 1 2 3 4 5 1 clinical path critical path critical clinical 2

2 3 4 5 2 31 3 31 117 1 1 2 3 4 5 1 2 RTP rapid turnover proteins RTP 3 RTP 4 CoA CoA CoA 5 1 31 4 31 118 1 1 2 20

3 E 3 NPC N 50 4 30 5 20 1 2 3 NPC N 150 200 NPC/N non-protein calorie/nitrogen 150 200 NPC/N / 2000kcal NPC/N 175 2000 175 NPC/N 300 500 NPC/N 100 150 20 30 4 30 TPN 15 30 24 300 30 1,000 5 10 10 2 3 2,000kcal 60 2,000 4 300 10 3,000 500 500 4.

4 000 4 31 5 31 119 1 1 LDL- 2 3 4 5 1 LDL- IIa III IIa 50 IIa 2 3 4 DNA RNA 5 3 31 6 31 120 1 1 2.

5 3 4 5 1 angiotensin converting enzyme ACE II 20 30 K K ACE 2 - - SU 3 PRPP 4 BMI 35 1992 3 5 pH 2 31 7 31 121 80 1 1 80 2 3 4 5 1 80 2 3 4

6 5 5 31 8 31 122 1 1 A 2 C 3 4 5 1 A - A A 2 D C BT CoA cAMP cGMP C D 3 C1 B12 4 5 DNA RNA 3 31 9 31 123 VLCD 1 1 2 6 3 4 1.

7 000kcal 5 1 Very Low Calorie Diet VLCD BMI30 2 1 4 6 3 4 200 600kcal VLDL 200 600kcal 30 70 20 50 1 2 1 5 VLDL 3 31 10 31 124 2 1,400kcal 1 1 1 70g 2 60g 3 110g 4 12g 5 10g 1 175 210g 50 60 1,400 4 175 210g 70 1 150 2 70g 15 20 1,400 4 70g 60g 3 kg 3 31 47g 20 30 1.

8 400 9 31 47g 110 4 8g 7g 8g 7g 6g 5 20g 1 20 2 31 11 31 125 1 1 2 3 SU 4 DPP-4 5 SGLT2 1 2 PPAR- , peroxisome proliferator-activated receptor- TNF- tumor necrosis factor- adipocytokine Na LDH CPK 3 SU sulfonyl urea.

9 SU SU ATP K 3 SU 6 24 4 DPP-4 incretin GLP-1 glucagon-like peptide-1 GIP glucose-dependent insulinotropic polypeptide DPP-4 DPP-4 SU 5 SGLT2 SGLT2 SGLT2, sodium glucose cotransporter-2 SGLT2 2 31 12 31 126