孕期膳食血糖生成指数变化与出生体重及母子胰岛素抵抗水平的关系

发布时间：2018-11-28 13:31

【摘要】：目的探讨超重孕妇孕期膳食血糖生成指数(GI)变化水平与新生儿出生体重及母子胰岛素抵抗水平的关系。方法选择在江苏省昆山市妇幼保健所及上海市国际和平妇幼保健院参加产检的超重孕妇为研究对象。前瞻性收集孕妇初次产检及孕中期膳食资料,计算GI变化水平(ΔGI)。采用Pearson相关分析ΔGI与新生儿出生体重、孕晚期空腹胰岛素及脐血C肽之间的相关关系,利用多元回归校正混杂因素的影响,进一步分析ΔGI与三者之间的关系。将ΔGI分为4组(25%、~50%、~75%和75%),出生体重分为巨大儿、正常体重儿、低出生体重儿3组,应用有序多分类Logistic回归分析孕期ΔGI和出生体重各分组之间的关系。结果本文共纳入392名超重孕妇,初诊和孕中期膳食GI平均水平分别为64.4±9.2和63.8±9.5,ΔGI为-0.6±12.7。孕晚期空腹胰岛素平均水平为11.6(7.4~15.8)μU·mL~(-1)。新生儿平均出生体重(3489.7±519.6)g,巨大儿发生率14.4%,脐血C肽的平均水平为0.7(0.4~1.0)ng·mL~(-1)。相关分析并未发现ΔGI与新生儿出生体重、孕晚期空腹胰岛素及脐血C肽之间的关系。多元线性逐步回归分析显示新生儿出生体重与ΔGI、孕期增重、新生儿性别、分娩孕周有关。有序多分类Logistic回归分析显示,随着孕期ΔGI的增加,新生儿出生体重呈上升趋势(OR=1.54,95%CI:1.06~2.25)。多元回归分析并未发现ΔGI与孕晚期空腹胰岛素、脐血C肽之间的关系。结论超重孕妇孕期膳食GI变化水平与新生儿出生体重显著相关,与母子胰岛素抵抗水平无关。
[Abstract]:Objective to investigate the relationship between the changes of dietary glucose production index (GI) and neonatal birth weight and maternal and child insulin resistance in overweight pregnant women. Methods overweight pregnant women who took part in birth examination in Kunshan Maternal and Child Health Institute and Shanghai International Peace Maternal and Child Health Institute were selected as study objects. The dietary data of first and second trimester of pregnant women were collected prospectively and the level of GI was calculated (螖 GI). The relationship between 螖 GI and neonatal birth weight, fasting insulin in late pregnancy and C-peptide in umbilical cord blood was analyzed by Pearson correlation analysis. The influence of mixed factors was corrected by multivariate regression, and the relationship between 螖 GI and the three factors was further analyzed. 螖 GI was divided into 4 groups (75% and 75%). The birth weight was divided into 3 groups: macrosomia, normal birth weight and low birth weight. The relationship between 螖 GI and birth weight was analyzed by Logistic regression analysis. Results the average dietary GI and 螖 GI were 64.4 卤9.2 and 63.8 卤9.5, and -0.6 卤12.7, respectively. The mean fasting insulin level was 11. 6 渭 U mL~ (- 1). The average birth weight of newborns was (3489.7 卤519.6) g, the incidence of macrosomia was 14.4%, and the average level of C-peptide in umbilical cord blood was 0.7 (0.4 卤1.0) ng mL~ (-1). Correlation analysis showed no correlation between 螖 GI and neonatal birth weight, fasting insulin in late pregnancy and C-peptide in umbilical cord blood. Multiple linear stepwise regression analysis showed that neonatal birth weight was related to 螖 GI, weight gain during pregnancy, sex of newborn, and gestational age of delivery. Logistic regression analysis showed that neonatal birth weight (OR=1.54,95%CI:1.06~2.25) increased with the increase of 螖 GI during pregnancy. Multiple regression analysis showed no correlation between 螖 GI and fasting insulin and C-peptide in umbilical cord blood. Conclusion the level of dietary GI in overweight pregnant women was significantly correlated with neonatal birth weight, but not with insulin resistance of mother and son.
【作者单位】：复旦大学附属儿科医院临床流行病学研究室;上海交通大学医学院附属国际和平妇幼保健院;江苏省昆山市妇幼保健所;
【基金】：国家自然科学基金项目:81273168
【分类号】：R153.1

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