【作者】 王子莲； 梁莹莹； 陈海天； 侯文杰； 李铭岚； 胡明晶；

【机构】 中山大学附属第一医院妇产科；

【摘要】 目的探讨妊娠中期宏量营养素(蛋白质、脂肪和碳水化合物)的摄入对妊娠期糖尿病发病的影响,为预防和干预妊娠期糖尿病的发生和发展、改善母婴结局提供科学依据。方法选择2005年11月至2006年8月到中山大学附属第一医院产科门诊进行产检的妊娠期糖尿病及妊娠期糖耐量异常孕妇131例作为研究对象(糖代谢异常组),正常孕妇128例作为对照组,应用食物频数问卷对妊娠中期膳食情况进行回顾分析。收集问卷后统计孕妇的一般情况,计算研究对象的总能量摄入以及碳水化合物、蛋白质和脂肪各自的供能,同时与对照组的结果进行比较。结果糖代谢异常组孕妇年龄、孕前体重、孕前体质指数、孕次、既往不良孕史的发生率和家庭收入显著高于对照组;两组间平均每天总能量摄入差异无统计学意义;糖代谢异常组平均每天总碳水化合物供能百分数低于对照组;平均每天总蛋白质供能百分数每增加一个单位,孕妇糖代谢异常的可能性增加6.5%。结论孕妇年龄、孕前体质指数和孕期增重是妊娠期糖代谢异常的影响因素,孕中期高蛋白质摄入与妊娠期糖代谢异常的发生有关;对妊娠中期的孕妇进行膳食营养教育和指导是降低妊娠期糖尿病发病的重要措施。更多还原

【Abstract】 Objective To investigate the relationship between dietary macronutrient intake,especially total caloric intake, carbohydrate and protein content(%kcal),and the development of gestational diabetes mellitus(GDM),so as to provide some scientific evidences for clinical monitoring,evaluation, interventions,and improve pregnancy outcome. Methods A retrospective observational study,standardized and criterion were performed.Data were from 259 wemen in the obstetrical out-patient clinics of the first affiliated hospital of Sun Yat-sen University from 1 November 2005 to 31 August 2006.They were divided into two groups:GDM group and normal glucose tolerance(NGT) group.wemen with GDM(GDM group,n=131) were compared with wemen with NGT(NGT group,n=128).Food diaries were obtained with a food-frequency questionnaire to assess their nutritional intake in terms of total calories,carbohydrate,protein and fat.Demographic characteristics and physical activities are also included.Results The age、prepregnant weight、body mass index、weight gain、family income and the incidence of pastobsterical illness in GDM group were significant higher than NGT group.There were no differences in calorie intake between the two group.Significant reductions in daily carbohydrate intake(%of energy) were seen among subjects in GDM group,while no differences were seen in protein and fat intake(%of energy).Adding 1%of protein to the diet was associated with a 6.5%increase in risk of GDM.Conclusion The mother’s age,prepregnant weight and BMI are risk factors of GDM.These study found a significant association between daily protein intake and the development of gestational diabetes mellitus in middle pregnancy.Dietary instructions in middle pregnancy conduce to preventing GDM induced by overeating and unbalanced diet decrease the incidence in a whole.更多还原