CAJ | 학술논문

目的：探讨小麦纤维素颗粒添加疗法对妊娠期糖尿病（gestational diabetes mellitus，GDM）患者血糖和血脂的影响，以及对 GDM 患者的最佳营养治疗方案。方法采取多中心随机对照临床研究，选取在孕24~28周诊断为 GDM 的患者180例，随机分为观察组和对照组，每组各90例，分别接受医学营养治疗+小麦纤维素颗粒和医学营养治疗4周。分别在治疗前、饮食干预4周后检测空腹血糖（ fasting plasma glucose，FPG）和餐后1 h、餐后2 h 血糖、糖化血红蛋白（ glycosylated hemoglobin，HbA1c）、总胆固醇（ total cholesterol，TC）、甘油三酯（triglyceride，TG）、高密度脂蛋白（high density lipid cholesterol，HDL）、低密度脂蛋白（low density lipid cholesterol，LDL）水平，比较两组妊娠结局情况。结果干预4周后两组 FPG、HDL 比较差异无统计学意义（P ＞0.05）；观察组餐后1 h、2 h 小时血糖、HbA1c、LDL、TC 和 TG[（9.60±1.71）mmol/ L、（7.90±1.48）mmol/ L、（4.40±0.7）%、（3.19±0.49）mmol/ L、（5.62±1.21）mmol/ L、（2.09±0.48）mmol/ L]均低于对照组[（10.30±1.68）mmol/ L、（8.90±1.65）mmol/ L、（4.80±0.8）%、（3.56±0.58）mmol/ L、（6.13±1.17）mmol/ L、（2.57±0.52）mmol/ L]，（P ＜0.05）；两组妊娠结局比较差异无统计学意义（P ＞0.05）。结论在 GDM 患者饮食中添加小麦纤维素颗粒4周可以显著改善 GDM 患者的血糖和血脂水平。
목적：탐토소맥섬유소과립첨가요법대임신기당뇨병（gestational diabetes mellitus，GDM）환자혈당화혈지적영향，이급대 GDM 환자적최가영양치료방안。방법채취다중심수궤대조림상연구，선취재잉24~28주진단위 GDM 적환자180례，수궤분위관찰조화대조조，매조각90례，분별접수의학영양치료+소맥섬유소과립화의학영양치료4주。분별재치료전、음식간예4주후검측공복혈당（ fasting plasma glucose，FPG）화찬후1 h、찬후2 h 혈당、당화혈홍단백（ glycosylated hemoglobin，HbA1c）、총담고순（ total cholesterol，TC）、감유삼지（triglyceride，TG）、고밀도지단백（high density lipid cholesterol，HDL）、저밀도지단백（low density lipid cholesterol，LDL）수평，비교량조임신결국정황。결과간예4주후량조 FPG、HDL 비교차이무통계학의의（P ＞0.05）；관찰조찬후1 h、2 h 소시혈당、HbA1c、LDL、TC 화 TG[（9.60±1.71）mmol/ L、（7.90±1.48）mmol/ L、（4.40±0.7）%、（3.19±0.49）mmol/ L、（5.62±1.21）mmol/ L、（2.09±0.48）mmol/ L]균저우대조조[（10.30±1.68）mmol/ L、（8.90±1.65）mmol/ L、（4.80±0.8）%、（3.56±0.58）mmol/ L、（6.13±1.17）mmol/ L、（2.57±0.52）mmol/ L]，（P ＜0.05）；량조임신결국비교차이무통계학의의（P ＞0.05）。결론재 GDM 환자음식중첨가소맥섬유소과립4주가이현저개선 GDM 환자적혈당화혈지수평。
Objective To explore the effect of fiber addition approach on glucose tolerance and lipid profiles in pregnant women with gestational diabetes mellitus( GDM),and to discuss the best nutrition treatment for patients with GDM. Methods The multicenter randomized controlled clinical trial was performed among 180 women diagnosed GDM at 24 ~ 28 weeks of gestation. Subjects were randomly assigned to observation group(n = 90)and control group(n = 90),who were given control diet + fiber addition approach or control diet only for 4 weeks. Fasting blood samples were taken at baseline and after 4 weeks of intervention to measure fasting plasma glucose( FPG),2 h postprandial blood glucose,glycosylated hemoglobin( HbA1c),et al,the perinatal outcomes were also compared between the two groups. Results There were no significant difference in FPG and HDL between two groups after 4 weeks intervention(P > 0. 05). 1 / 2 h postprandial blood glucose,HbA1c,LDL,TC,TG of observation group[(9. 60 ± 1. 71)mmol/ L、(7. 90 ± 1. 48)mmol/ L、(4. 40 ± 0. 7)% 、(3. 19 ± 0. 49)mmol/ L、(5. 62 ± 1. 21)mmol/ L、(2. 09 ± 0. 48)mmol/ L respectively]were lower than those of control group[(10. 30 ± 1. 68)mmol/ L、(8. 90 ± 1. 65)mmol/ L、(4. 80 ± 0. 8)% 、(3. 56 ± 0. 58)mmol/ L、(6. 13 ± 1. 17)mmol/ L、(2. 57 ± 0. 52)mmol/ L respectively]( P < 0. 05). There was no significant difference in perinatal outcomes between two groups(P > 0. 05). Conclusion Consumption of the fibre pattern for 4 weeks among pregnant women with GDM resulted in beneficial effects on glucose tolerance and lipid profiles compared with the control diet.