低血糖负荷膳食干预对超重、肥胖孕妇营养和新生儿DNA甲基化影响研究

发布时间：2018-11-25 16:02

【摘要】：目的：通过对超重孕妇实施低GI膳食的干预,了解孕期妇女膳食营养素摄入变化情况,探讨胎盘组织和脐血中体重增长有关基因甲基化的改变,为我国特殊人群(超重、肥胖孕妇)的疾病预防提供一种新的干预模式提供科学依据。方法：本研究采用随机化单盲对照干预试验设计,针对初次产检超重、肥胖的孕妇,在我国孕产妇保健规范基础上实施低GI(低血糖生成指数)膳食的干预,膳食干预组对照组各纳入25例孕妇；观察孕妇孕期膳食和营养素摄入量,使用24小时膳食问卷调查不同孕期孕妇的膳食、营养素摄入量情况；用问卷调查方式获取孕妇人口学、孕期暴露因素基本信息,分析两组孕妇间营养素摄入情况。孕妇分娩时收集脐血和胎盘组织,提取DNA,采用Illumina甲基化芯片进行两步法全基因组甲基化测定,分析膳食干预组与对照组差异的甲基化基因位点,对差异基因功能进行生物信息学分析。结果：①孕早期和孕中期孕妇能量摄入量均未达到推荐的摄入量(RNI),孕早期能量摄入为1633.3kcal,为推荐摄入量的77.8%,孕中期1679.9kcal,为推荐摄入量的73.0%。孕早期蛋白质摄入量为推荐摄入量的88.6%,孕中期蛋白质摄入量为推荐摄入量的95.0%。孕早、中期维生素A的摄入量为推荐摄入的91.2%,98.6%。维生素B1为推荐摄入的57.4%,57.3%；维生素B2为推荐摄入的58.8%,80.6%；维生素B3、E均超过推荐摄入量；维生素C为推荐摄入的125.6%,96.8%。孕早、中期钙的摄入量达到适宜摄入量(AI)的63.1%,81.5%；铁的摄入量为AI的111.0%,73.2%。比较膳食干预组与对照组的营养素摄入情况,孕早期脂肪摄入两组间有差异(P0.05),未见其他营养素在两组间有差异；孕中期维生素E摄入两组间差异有统计学意义(P0.05),其他营养素在两组间差异无统计学意义。 ②分析膳食干预组与对照组母亲孕期暴露、胎儿出生基本资料,母亲孕期基本资料两组间未达到显著性,但是干预组母亲的孕前BMI比对照组略高；膳食干预组胎儿出生体重高于对照组出生体重(3.7±0.5Kg VS.3.5±0.4Kg, P=0.248),差异无统计学意义。 ③根据小样本的实验结合生物信息数据库分析,共筛选出19个基因位点,所属18个基因,有5个基因位于1号染色体,2个基因位于7号染色体,其余基因分布比较分散。比较干预组与对照组基因位点甲基化的改变,发现脐血中有2个差异的甲基化位点CpG位点,分别位于TEKT5基因、MIR378C基因上,胎盘中发现1个差异的甲基化位点CpG位点,所属PGBD5基因。结论：本研究人群孕妇膳食种类丰富,但营养素摄入水平不均衡,通过对超重孕妇采取低GI膳食的干预,可以改变胎盘组织和脐血中基因的甲基化的改变,对子代的健康成长有重要的意义。
[Abstract]:Objective: to investigate the changes of dietary nutrient intake in pregnant women through the intervention of low GI diet in overweight women, and to explore the changes of methylation of genes related to weight gain in placental tissue and umbilical cord blood. The disease prevention of obese pregnant women provides a new intervention model to provide scientific basis. Methods: a randomized, single-blind, controlled intervention trial was designed to treat pregnant women who were overweight and obese at the first time. The intervention of low GI diet was carried out on the basis of maternal health standards in China. The diet intervention group included 25 pregnant women in each group. The diet and nutrient intake of pregnant women during pregnancy were observed, and the dietary and nutrient intake of pregnant women during different pregnancy were investigated by a 24-hour dietary questionnaire. The demographics of pregnant women and the basic information of exposure factors during pregnancy were obtained by questionnaire, and the nutrient intake between the two groups was analyzed. Umbilical cord blood and placental tissue were collected during delivery. DNA, was extracted by Illumina methylation microarray to detect the whole genome methylation. The difference of methylation gene sites between the diet intervention group and the control group was analyzed. The differential gene function was analyzed by bioinformatics. Results: 1 the energy intake of pregnant women in the first trimester and the second trimester was not up to the recommended intake. The energy intake of (RNI), in early pregnancy was 1633.3 kcal, which was 77.8 kcal of the recommended intake, 1679.9 kcal in the second trimester, and 73.0 kcal in the second trimester. The protein intake in the first trimester was 88.6 of the recommended intake, and the protein intake in the second trimester was 95.0. The intake of vitamin A in the first trimester and middle trimester was 91.2% and 98.6% of the recommended intake. Vitamin B1 is the recommended intake of 57.3; Vitamin B2 is the recommended intake of 58.80.86; Vitamin B3E is more than the recommended intake; Vitamin C is the recommended intake of 125.6%. In the first trimester of pregnancy, the intake of calcium reached 63.1% and 81.5% of the appropriate intake of (AI), while the intake of iron was 111.0% and 73.2% of AI. Compared with the dietary intervention group and the control group intake of nutrients, early pregnancy fat intake between the two groups there was a difference (P0.05), there is no difference in other nutrients between the two groups; There was significant difference in vitamin E intake between the two groups in the second trimester of pregnancy (P0.05), but there was no significant difference in other nutrients between the two groups. (2) there was no significant difference in maternal exposure and fetal birth data between the two groups, but the pre-pregnancy BMI of the intervention group was slightly higher than that of the control group. The fetal birth weight in the dietary intervention group was higher than that in the control group (3.7 卤0.5Kg VS.3.5 卤0.4 kg, P0. 248), and there was no significant difference. 3According to the experiment of small sample and the analysis of biological information database, 19 gene loci were screened out, of which 5 genes were located on chromosome 1, 2 genes were located on chromosome 7, and the other genes were scattered. Compared with the control group, we found that there were two different CpG sites in the umbilical cord blood, which were located on the TEKT5 gene, MIR378C gene, and a different CpG site in the placenta. Belongs to PGBD5 gene. Conclusion: the diet of pregnant women in this study is abundant, but the level of nutrient intake is not balanced. The methylation of genes in placenta and umbilical cord blood can be changed by intervention of low GI diet on overweight women. It is of great significance to the healthy growth of the offspring.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R715.3

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