孕早期膳食结构与妊娠期糖尿病关系的临床研究

Relationship between first trimester diet and gestational diabetes mellitus

目的了解妊娠早期孕妇的膳食结构特点,并探讨其与妊娠期糖尿病(GDM)的关系。方法选取孕早期产检妇女1 500例进行孕早期膳食调查,并于孕中期对所有孕妇进行GDM筛查。选取确诊为GDM的孕妇130例作为GDM组,随机抽取与之匹配的健康孕妇130例为对照组,对两组孕妇孕早期三大营养素摄入比进行对照研究,用Logistic回归分析法探讨三大营养素与GDM发病的关系。结果 GDM组孕妇平均每天蛋白质供能百分比[(12.47±5.51)%]低于对照组,总碳水化合物供能百分比[(58.56±10.40)%]高于对照组(均P<0.05);低蛋白膳食是GDM的独立危险因素(P<0.05)。结论孕早期低蛋白和高碳水化合物摄入与GDM的发病有关;对孕早期孕妇进行膳食摄入的教育和指导可以有效降低孕中期GDM的发生。

Objective To study characteristics of maternal diet during early pregnancy, and explore its relationship with gestational diabetes mellitus （GDM）. Methods Totally 1 500 women during early pregnancy were enrolled to receive a survey on first trimester diet. In the second trimester, all the women were examined and screened for GDM. One hundred and thirty pregnant women diagnosed with GDM served as GDM group, and 130 cases of healthy pregnant women served as control group. Case-control study was carried out between the two groups in terms of intake of three macro nutrients during early pregnancy. The associations of first tri mester diet with development of gestational diabetes were analyzed by using multi-factor regression analysis. Results The energy percentage of protein in GDM group E（12.47±5.51）% was lower than that in the control group, while the energy percentage of total carbohydrates was significantly higher in GDM group [（58.56±10.40）%] than in the control group （P〈0. 05 for all）. Lowprotein diet is an independent risk factor for GDM （P〈0.05）. Conelusion Low-protein diet and high-carbohydrate intake are posi tively correlated with GDM. Education and guidance of dietary intake on early pregnancy can effectively reduce the incidence of GDM in second trimester.