膳食营养成分与妊娠期糖尿病的相关性研究

A research on relationships between dietary nutrient composition and gestational diabetes mellitus

目的 探讨孕妇饮食营养成分比例与妊娠期糖尿病发病情况的关系.方法 对2 600例孕妇在中孕期进行饮食问卷调查.根据糖尿病筛查将孕妇分为正常、糖耐量异常和妊娠期糖尿病3组,调整混杂因素的影响后利用Logistic回归方法 分析膳食营养比例对妊娠期糖耐量异常和妊娠期糖尿病相对危险度的影响.结果 妊娠期糖耐量异常的发生率为13.19%,妊娠期糖尿病的发生率为6.92%.将正常孕妇每天饮食中的碳水化合物或蛋白质比例分别降低10%,并替代以脂肪,与调整饮食结构以前相比,妊娠期糖尿病发病危险性可高达6.55和2.19倍.结论 过多脂肪的摄入可能促发妊娠期糖尿病,孕期应采取膳食干预措施,减少妊娠期糖尿病的发生.

Objective To explore relationships between dietary nutrients intake of pregnant women and development of gestational diabetes mellitus（GDM）. Methods 2 600 pregnant women in the second trimester of pregnancy who visited our hospital were investigated with a questionnaire for their dietary intake during pregnancy. The pregnant women were divided into 3 groups according to diabetes mellitus screening standard： GDM group, impaired glucose tolerance （IGT） group and normal glucose tolerance group. Multivariate logistic regression was used to calculate the relative risk of proportion of nutrients for IGT and GDM after adjustment for potential confounders. Results The overall prevalence of IGT and GDM in the cohort were 6.92% and 13.19% respectively. The substitution model showed that substituting fat for carbohydrates or proteins for those normal pregnant women （per 10% of total calories） resulted in a significant increase in risks of both IGT and GDM and the relative risk of IGT and GDM were increased by 6.55 times and 2.19 times respectively as copmared with those before the nutrients substitution. Conclusion Excessive intake of fat could promote development of GDM. The dietary intervention during pregnancy for pregnant women should be taken in order to reduce incidence of GDM.