中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
14期
1624-1628
,共5页
糖尿病,妊娠%糖尿病膳食%膳食调查%口服葡萄糖耐量试验%人体质量指数%体重增长
糖尿病,妊娠%糖尿病膳食%膳食調查%口服葡萄糖耐量試驗%人體質量指數%體重增長
당뇨병,임신%당뇨병선식%선식조사%구복포도당내량시험%인체질량지수%체중증장
Diabetes,gestationa%Diabetic diet%Diet surveys%Oral glucose tolerance test%Body mass index%Weight gain
目的：探讨妊娠糖尿病（GDM）患者孕前体质指数（BMI）与孕中期营养素摄入水平及孕期增重的关系，探讨其对 GDM 发病的影响，为进一步指导孕期营养提供科学依据。方法选择2013年10月—2014年10月在北京友谊医院营养门诊就诊的170例 GDM 患者为调查对象，根据孕前 BMI 分为低体质量组、正常体质量组、超重组、肥胖组，使用24 h 膳食回顾调查法和食物频度法，分析 GDM 患者孕中期营养素摄入量，对孕前 BMI 与口服葡萄糖耐量试验（OGTT）结果、孕期增重与摄入总能量进行相关分析。结果 OGTT 结果显示肥胖组患者空腹血糖、餐后1 h 血糖、餐后2 h 血糖水平高于低体质量组和正常体质量组（P ＜0.05）；超重组患者空腹血糖、餐后1 h 血糖水平高于低体质量组和正常体质量组（P ＜0.05）；正常体质量组空腹血糖水平高于低体质量组（P ＜0.05），正常体质量组与低体质量组餐后1 h 血糖、餐后2 h 血糖水平比较，差异均无统计学意义（ P ＞0.05）。不同 BMI 组 GDM 患者摄入的总能量、总蛋白、总脂肪及总碳水化合物比较，差异均无统计学意义（P ＞0.05）。低体质量组活动时间较其他3组活动时间多，差异有统计学意义（P ＜0.05）。4组孕期增重比较，差异无统计学意义（ P ＞0.05）。GDM 患者孕前 BMI 与OGTT 空腹血糖水平呈正相关（r ＝0.387，P ＜0.05）；与餐后1 h 血糖水平呈正相关（r ＝0.279，P ＜0.05）；与餐后2 h 血糖水平呈正相关（r ＝0.164，P ＜0.05）。孕期增重与孕期摄入总能量呈正相关（r ＝0.242，P ＜0.05）。结论孕前超重或肥胖、孕期饮食结构不合理及孕期增重过多均与 GDM 相关；孕期应合理饮食、均衡营养，同时应加强孕妇营养健康教育及围生期保健，控制体质量的合理增长，降低 GDM 的发病率，提高母婴健康水平。
目的：探討妊娠糖尿病（GDM）患者孕前體質指數（BMI）與孕中期營養素攝入水平及孕期增重的關繫，探討其對 GDM 髮病的影響，為進一步指導孕期營養提供科學依據。方法選擇2013年10月—2014年10月在北京友誼醫院營養門診就診的170例 GDM 患者為調查對象，根據孕前 BMI 分為低體質量組、正常體質量組、超重組、肥胖組，使用24 h 膳食迴顧調查法和食物頻度法，分析 GDM 患者孕中期營養素攝入量，對孕前 BMI 與口服葡萄糖耐量試驗（OGTT）結果、孕期增重與攝入總能量進行相關分析。結果 OGTT 結果顯示肥胖組患者空腹血糖、餐後1 h 血糖、餐後2 h 血糖水平高于低體質量組和正常體質量組（P ＜0.05）；超重組患者空腹血糖、餐後1 h 血糖水平高于低體質量組和正常體質量組（P ＜0.05）；正常體質量組空腹血糖水平高于低體質量組（P ＜0.05），正常體質量組與低體質量組餐後1 h 血糖、餐後2 h 血糖水平比較，差異均無統計學意義（ P ＞0.05）。不同 BMI 組 GDM 患者攝入的總能量、總蛋白、總脂肪及總碳水化閤物比較，差異均無統計學意義（P ＞0.05）。低體質量組活動時間較其他3組活動時間多，差異有統計學意義（P ＜0.05）。4組孕期增重比較，差異無統計學意義（ P ＞0.05）。GDM 患者孕前 BMI 與OGTT 空腹血糖水平呈正相關（r ＝0.387，P ＜0.05）；與餐後1 h 血糖水平呈正相關（r ＝0.279，P ＜0.05）；與餐後2 h 血糖水平呈正相關（r ＝0.164，P ＜0.05）。孕期增重與孕期攝入總能量呈正相關（r ＝0.242，P ＜0.05）。結論孕前超重或肥胖、孕期飲食結構不閤理及孕期增重過多均與 GDM 相關；孕期應閤理飲食、均衡營養，同時應加彊孕婦營養健康教育及圍生期保健，控製體質量的閤理增長，降低 GDM 的髮病率，提高母嬰健康水平。
목적：탐토임신당뇨병（GDM）환자잉전체질지수（BMI）여잉중기영양소섭입수평급잉기증중적관계，탐토기대 GDM 발병적영향，위진일보지도잉기영양제공과학의거。방법선택2013년10월—2014년10월재북경우의의원영양문진취진적170례 GDM 환자위조사대상，근거잉전 BMI 분위저체질량조、정상체질량조、초중조、비반조，사용24 h 선식회고조사법화식물빈도법，분석 GDM 환자잉중기영양소섭입량，대잉전 BMI 여구복포도당내량시험（OGTT）결과、잉기증중여섭입총능량진행상관분석。결과 OGTT 결과현시비반조환자공복혈당、찬후1 h 혈당、찬후2 h 혈당수평고우저체질량조화정상체질량조（P ＜0.05）；초중조환자공복혈당、찬후1 h 혈당수평고우저체질량조화정상체질량조（P ＜0.05）；정상체질량조공복혈당수평고우저체질량조（P ＜0.05），정상체질량조여저체질량조찬후1 h 혈당、찬후2 h 혈당수평비교，차이균무통계학의의（ P ＞0.05）。불동 BMI 조 GDM 환자섭입적총능량、총단백、총지방급총탄수화합물비교，차이균무통계학의의（P ＞0.05）。저체질량조활동시간교기타3조활동시간다，차이유통계학의의（P ＜0.05）。4조잉기증중비교，차이무통계학의의（ P ＞0.05）。GDM 환자잉전 BMI 여OGTT 공복혈당수평정정상관（r ＝0.387，P ＜0.05）；여찬후1 h 혈당수평정정상관（r ＝0.279，P ＜0.05）；여찬후2 h 혈당수평정정상관（r ＝0.164，P ＜0.05）。잉기증중여잉기섭입총능량정정상관（r ＝0.242，P ＜0.05）。결론잉전초중혹비반、잉기음식결구불합리급잉기증중과다균여 GDM 상관；잉기응합리음식、균형영양，동시응가강잉부영양건강교육급위생기보건，공제체질량적합리증장，강저 GDM 적발병솔，제고모영건강수평。
Objective To investigate the pre - pregnancy body mass index,nutrition intake during second trimester and weight gain during pregnancy of women with gestational diabetes mellitus(GDM)and to explore the effects of those factors on the pathogenesis of GDM,so as to provide a further scientific basis for nutritional guidance during pregnancy. Methods A total of 170 cases of patients with GDM who received treatment in the nutrition outpatient department of Beijing Friendship Hospital from October 2013 to October 2014 were enrolled in this study. According to pre - pregnancy body mass index,the subjects were divided into four groups:low weight group,normal weight group,overweight group and obesity group. By using 24 h dietary recall survey and food frequency survey method,dietary intake of nutrient during the second trimester was analyzed. Pearson correlation analyses were conducted on pre - pregnancy BMI,OGTT results,weight gain during pregnancy and total energy intake from diet. Results The obesity group was higher(P < 0. 05)than low weight group and normal weight group in fasting blood glucose and the 1 h and 2 h blood glucose after a meal;the over weight group was higher( P < 0. 05)than low weight group and normal weight group in fasting blood glucose and the 1 h blood glucose after OGTT;the normal weight group was higher (P < 0. 05)than the low weight group in fasting blood glucose;the normal weight group was not significantly different( P >0. 05)than the low weight group in 1 h and 2 h blood glucose after OGTT. The four groups were not significantly different(P >0. 05)in the total intake of energy,protein,fat and carbohydrate. The low weight group was higher(P < 0. 05)than the other three groups in exercise time. The four groups were not significantly different(P > 0. 05)in weight gain during pregnancy. The BMI before pregnancy was positively correlated( r = 0. 387,P < 0. 05)with fasting blood glucose,positively correlated( r =0. 279,P < 0. 05)with 1 h blood glucose after a meal and also positively correlated( r = 0. 164,P < 0. 05)with 2 h blood glucose after a meal. The weight gain during pregnancy was positively correlated(r = 0. 242,P < 0. 05)with the total intake of energy during pregnancy. Conclusion Overweight or obesity before pregnancy,unreasonable diet structure and excessive weight gain during pregnancy have correlation with gestational diabetes mellitus. Reasonable diet during pregnancy,balanced nutrition, the promotion of education about nutrition,the improvement of health care during perinatal period,the control of body weight within a reasonable increase may reduce the incidence of GDM and improve maternal and infant health.
