CAJ | 학술논문

目的：观察膳食脂肪改变对妊娠糖尿病（GDM）患者的影响。方法选取2011年1月—2013年1月在常州市妇幼保健院产科门诊确诊的 GDM 患者84例，按区组随机化法分为试验组（41例）和对照组（43例）。在总能量和蛋白质供能比不变的前提下，试验组给予多油配餐，烹饪油45～50 g/ d，脂肪供能比为31％～35％；对照组给予传统少油配餐，烹调油20 g/ d，脂肪供能比为25％～30％。对比分析两组患者餐后血糖、脂质代谢、胰岛素及妊娠结局。结果干预后，试验组脂肪及其供能比、饱和脂肪酸（SFA）及其供能比、单不饱和脂肪酸（MUFA）及其供能比、多不饱和脂肪酸（PUFA）及其供能比高于对照组，碳水化合物及其供能比低于对照组，差异有统计学意义（P＜0.05）。试验组干预后总能量、蛋白质、脂肪、碳水化合物及其供能比，MUFA 及其供能比较干预前下降，蛋白质供能比、脂肪供能比、PUFA 及其供能比较干预前升高，差异有统计学意义（P ＜0.05）；对照组干预后总能量、蛋白质、脂肪及其供能比，碳水化合物、SFA、MUFA 及其供能比较干预前下降，蛋白质供能比、PUFA 供能比较干预前升高，差异有统计学意义（P ＜0.05）。干预后两组空腹血糖（FBG）、餐后2 h 血糖、高密度脂蛋白胆固醇（HDL - C）均较干预前下降，胰岛素敏感指数（IAI）、三酰甘油（TG）较干预前升高，差异有统计学意义（ P ＜0.05）。两组妊娠结局差异无统计学意义（P ＞0.05）。结论膳食脂肪摄入干预后，GDM 患者血糖、脂质代谢、胰岛素抵抗情况得到好转。GDM 的饮食治疗应遵照基本原则、严格控制总能量的摄入，适当增加植物油中 PUFA 的摄入对孕妇和胎儿有益。
목적：관찰선식지방개변대임신당뇨병（GDM）환자적영향。방법선취2011년1월—2013년1월재상주시부유보건원산과문진학진적 GDM 환자84례，안구조수궤화법분위시험조（41례）화대조조（43례）。재총능량화단백질공능비불변적전제하，시험조급여다유배찬，팽임유45～50 g/ d，지방공능비위31％～35％；대조조급여전통소유배찬，팽조유20 g/ d，지방공능비위25％～30％。대비분석량조환자찬후혈당、지질대사、이도소급임신결국。결과간예후，시험조지방급기공능비、포화지방산（SFA）급기공능비、단불포화지방산（MUFA）급기공능비、다불포화지방산（PUFA）급기공능비고우대조조，탄수화합물급기공능비저우대조조，차이유통계학의의（P＜0.05）。시험조간예후총능량、단백질、지방、탄수화합물급기공능비，MUFA 급기공능비교간예전하강，단백질공능비、지방공능비、PUFA 급기공능비교간예전승고，차이유통계학의의（P ＜0.05）；대조조간예후총능량、단백질、지방급기공능비，탄수화합물、SFA、MUFA 급기공능비교간예전하강，단백질공능비、PUFA 공능비교간예전승고，차이유통계학의의（P ＜0.05）。간예후량조공복혈당（FBG）、찬후2 h 혈당、고밀도지단백담고순（HDL - C）균교간예전하강，이도소민감지수（IAI）、삼선감유（TG）교간예전승고，차이유통계학의의（ P ＜0.05）。량조임신결국차이무통계학의의（P ＞0.05）。결론선식지방섭입간예후，GDM 환자혈당、지질대사、이도소저항정황득도호전。GDM 적음식치료응준조기본원칙、엄격공제총능량적섭입，괄당증가식물유중 PUFA 적섭입대잉부화태인유익。
Objective To investigate the effect of dietary fat changes on pregnant women with GDM. Methods 84 GDM pregnant women,which were the patients of Changzhou Woman and Children Health - care Hospital from Jan. 2011 to Jan. 2013,were randomly divided into experiment group(41 cases)and control group(43 cases). They were all under the same situations of total energy and protein intake. The patients in experiment group were given the oil - richer meals which oil is 45 - 50 g/ d and the energy supply ratio of fat is 31% to 35% . The patients in control group were given the conventional oil - less meals which oil is 20 g/ d and the energy supply ratio of fat is 25% to 30% . Comparative analysis was taken between pregnant women of the two groups,including postprandial blood glucose,lipid metabolism,insulin and the pregnancy outcome. Results After the intervention,the intake of fat,energy supply ratio of fat and fatty acids in the patients of experiment group were higher than that in the patients of control group,while carbohydrates intake and its energy supply ratio in experiment group were lower than that in control group( P < 0. 05). In the patients of experiment group,the intake of total energy,protein,fat, carbohydrates and its energy supply ratio,monounsaturated fatty acids(MUFA)and its energy supply ratio were decreased than the pre - intervention;while energy supply ratio of protein and fat,the intake of polyunsaturated fatty acids( PUFA)and its energy supply ratio were increased than the pre - intervention(P < 0. 05). In the patients of control group,the intake of total energy,protein,fat and its energy supply ratio,carbohydrates,SFA,MUFA and its energy supply ratio were decreased than the pre - intervention;while energy supply ratio of protein and PUFA were increased than the pre - intervention(P < 0. 05). After the intervention,fasting blood glucose( FBG),postprandial blood glucose for 2 h(2 hPG),high density lipoprotein cholesterol(HDL - C)in two groups were decreased than the pre - intervention(P < 0. 05);while insulin sensitivity index (IAI),triglyceride(TG)were increased than the pre - intervention(P < 0. 05). The pregnancy outcomes had no statistically difference between the two groups(P > 0. 05). Conclusion After the dietary fatty intervention,GDM blood glucose,lipid metabolism,insulin resistance were improved. The diet therapy of GDM needs to obey the basic rules and control the total energy intake strictly. After that,the reasonable increase of PFUA may have benefit on pregnant women and fetuses.