妊娠期糖尿病与膳食摄入、红细胞膜磷脂脂肪酸谱的相关性研究

发布时间：2018-01-14 22:01

  本文关键词：妊娠期糖尿病与膳食摄入、红细胞膜磷脂脂肪酸谱的相关性研究　出处：《宁夏医科大学》2017年硕士论文　论文类型：学位论文

  更多相关文章： 妊娠期糖尿病 胰岛素抵抗指数 空腹胰岛素 不饱和脂肪酸

【摘要】：目的:本课题的目的是研究膳食摄入、红细胞膜磷脂脂肪酸谱与妊娠期糖尿病(GDM)的关系。方法:2016.3~2016.9我们在济宁市第一人民医院征集了日常产检并正常分娩的73名GDM孕晚期孕妇和74名健康孕晚期孕妇,分别作为病例组(GDM组)和对照组(NGT组),收集孕产妇的基本生理生化指标等参数,记录七天膳食摄入并采用气相色谱仪检测红细胞膜磷脂脂肪酸谱,统计分析两组孕产妇膳食、红细胞膜磷脂脂肪酸谱差异,采用二分类非条件logistic回归研究GDM发病的影响因素,通过偏相关分析探讨GDM与膳食摄入、红细胞膜磷脂脂肪酸谱之间的相关性。结果:1.GDM组与NGT组相比较,年龄、宫高、腹围、孕周、孕前体重、产前体重、孕期增重、体质指数(BMI)、胎儿体重、Apgar评分、尿酸(UA)、肌酐(Cr)、白蛋白(ALB)、胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FIns)指标差异均有统计学意义(P0.05);2.膳食摄入情况:GDM组蛋白摄入量显著高于NGT组(108.50±19.21g vs.99.16±16.40 g)、GDM组脂肪摄入量显著高于NGT组(103.53±21.99g vs.93.32±18.67 g)、GDM组碳水化合物摄入量显著高于NGT组(357.03±51.80g vs.292.39±52.60g);GDM组膳食总能量显著高于NGT组(2648.82 kcal vs.2305.42 kcal);GDM组VitB1、VitB2、VitC、VitPP、钾、钠、镁、铁、锌、磷、苏氨酸、谷粮能量、果类能量、肉类能量、蔬菜能量、蛋类能量显著高于NGT组,而鱼虾能量NGT组显著高于GDM组(90.19 kcal vs.37.73 kcal),差异均有统计学意义(P0.05);3.红细胞膜磷脂脂肪酸谱:NGT组C16:0、C18:0、总饱和脂肪酸(SFA)、总n-6多不饱和脂肪酸(PUFA)/n-3 PUFA显著高于GDM组,GDM组总单不饱和脂肪酸(MUFA)、总PUFA、总MUFA/SFA、C22:6n-3、C18:1n-9、C22:5n-3、C22:6n-3、n-3PUFAs显著高于NGT组,差异均有统计学意义(P0.05);4.BMI≥24 Kg/m2(OR=2.874)、年龄≥30y(OR=3.638)、孕期增重≥12.5 kg(OR=9.201)是GDM危险因素,每周坚果食用≥50 g(OR=0.301)是GDM保护因素;5.空腹胰岛素与C16:0、C20:3n-3、n-6/n-3 PUFAs、总能量、蛋白、碳水化合物、钾、镁、果类能量、豆类能量及其供能比之间成正相关,与C24:0、C22:6n-3、总LC-MUFA、n-3 PUFAs成负相关,差异均有统计学意义(P0.05);胰岛素抵抗指数与总能量、蛋白、钾、钙、镁、磷、豆类能量、C16:0、C20:3n-3、n-6/n-3 PUFAs成正相关,与C24:0、C20:1n-9、C22:5n-3、C22:6n-3、总PUFA、总长链单不饱和脂肪酸(LC-MUFA)、n-3PUFAs成负相关,差异均有统计学意义(P0.05)。结论:1.孕妇年龄≥30y,BMI≥24 Kg/m2,孕期增重≥12.5 kg会增加GDM的发病风险,而每周食用坚果类食物≥50 g可以有效防止GDM的发生;2.GDM孕妇较NGT孕妇膳食特点为高能量、高蛋白、高脂肪、高碳水化合物;3.孕妇在妊娠期间增加摄入不饱和脂肪酸,尤其是n-3 PUFAs,减少SFA的摄入,可能与降低胰岛素抵抗指数以及空腹胰岛素水平有关。
[Abstract]:Objective: the purpose of this study is to study dietary intake. Erythrocyte membrane phospholipid fatty acid spectrum and gestational diabetes mellitus (GDM). Methods We collected 73 GDM late pregnant women and 74 healthy third trimester pregnant women in the first people's Hospital of Jining. As the case group (GDM group) and control group (NGT group), collect the basic physiological and biochemical parameters of pregnant and lying-in women. Seven days dietary intake was recorded and red blood cell membrane phospholipid fatty acid spectrum was detected by gas chromatograph. The difference of maternal diet and erythrocyte membrane phospholipid fatty acid spectrum between the two groups was analyzed statistically. The factors influencing the incidence of GDM were studied by two-class unconditioned logistic regression, and the relationship between GDM and dietary intake was discussed by partial correlation analysis. Results 1. Age, uterus height, abdominal circumference, gestational age, pre-pregnancy weight, prenatal weight, weight gain during pregnancy in GDM group were higher than those in NGT group. Body mass index (BMI), fetal body weight (FW) Apgar score, uric acid (UAA), creatinine (Cr), Albumin (ALB), insulin resistance index (HOMA-IRR). The difference of fasting insulin FIns was statistically significant (P 0.05). 2.The dietary intake of protein in the NGT group was significantly higher than that in the NGT group (108.50 卤19.21g vs.99.16 卤16.40g). The fat intake of GDM group was significantly higher than that of NGT group (103.53 卤21.99g vs.93.32 卤18.67g). Carbohydrate intake in GDM group was significantly higher than that in NGT group (357.03 卤51.80 g vs.292.39 卤52.60 g / g). The total dietary energy of GDM group was significantly higher than that of NGT group (2648.82 kcal vs.2305.42 kcal). In GDM group, VitB1Vit B2Vit, potassium, sodium, magnesium, iron, zinc, phosphorus, threonine, grain energy, fruit energy, meat energy, vegetable energy. Egg energy was significantly higher than NGT group, while fish and shrimp energy NGT group was significantly higher than GDM group (90.19 kcal vs.37.73 kcal). The difference was statistically significant (P 0.05). 3.The fatty acid spectrum of erythrocyte membrane phospholipid in group C 16: 0: C 18: 0, total saturated fatty acid (SFA). The total n-6 polyunsaturated fatty acid (PUFAA) / n-3 PUFA was significantly higher than that in GDM group (total monounsaturated fatty acid), total monounsaturated fatty acid (MUFA/SFA) and total monounsaturated fatty acid (MUFA/SFA). C22: 6n-3 + C18: 1n-9 / C22: 5n-3C22: 6n-3 PUFAs were significantly higher than those of NGT group (P 0.05). 4. BMI 鈮，

本文编号：1425461