膳食脂肪改变对妊娠糖尿病患者影响的随机对照研究

发布时间：2018-12-17 20:01

【摘要】：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(P0.05)。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(P0.05);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(P0.05)。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(P0.05)。两组妊娠结局差异无统计学意义(P0.05)。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。
[Abstract]:Objective to observe the effect of dietary fat changes on gestational diabetes mellitus (GDM) patients. Methods from January 2011 to January 2013, 84 patients with GDM were randomly divided into trial group (n = 41) and control group (n = 43). Under the condition that the energy ratio of total energy to protein was not changed, the experimental group was given more oil, cooking oil, 45g / d, and fat / energy ratio, 31g / 35g / d; The control group was given traditional less oil meal, cooking oil 20 g / d, fat energy ratio was 25 / 30. Postprandial blood glucose, lipid metabolism, insulin and pregnancy outcome were compared between the two groups. Results after intervention, the ratio of fat to energy, saturated fatty acid (SFA) and its energy supply ratio, monounsaturated fatty acid (MUFA) and its energy supply ratio, polyunsaturated fatty acid (PUFA) and their energy supply ratio in the experimental group were higher than those in the control group. Carbohydrate and its energy supply ratio was lower than the control group, the difference was statistically significant (P0.05). After intervention, total energy, protein, fat, carbohydrate and their energy supply ratio, MUFA and their energy supply ratio, protein to energy ratio, fat to energy ratio, PUFA and their energy supply increased after intervention. The difference was statistically significant (P0.05). In the control group, the total energy, protein, fat and energy supply ratio, carbohydrate, SFA,MUFA and their energy supply ratio decreased, protein energy supply ratio and PUFA energy supply ratio increased after intervention, the difference was statistically significant (P0.05). After intervention, fasting blood glucose (FBG), high density lipoprotein cholesterol (HDL-C) and insulin sensitive index (IAI),) triacylglycerol (TG) increased in both groups after 2 h postprandial intervention. The difference was statistically significant (P0.05). There was no significant difference in pregnancy outcome between the two groups (P0.05). Conclusion the glucose, lipid metabolism and insulin resistance in patients with GDM can be improved after the intervention of dietary fat intake. The dietary treatment of GDM should follow the basic principles and strictly control the total energy intake. Proper increase in the intake of PUFA in vegetable oil is beneficial to pregnant women and fetuses.
【作者单位】：南京医科大学附属常州妇幼保健院产科;南京医科大学附属常州妇幼保健院营养科;南京医科大学附属常州妇幼保健院检验科;
【基金】：常州市科技局项目(20102006)
【分类号】：R714.256

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