妊娠糖尿病患者营养素摄入情况及影响因素分析

Analysis on Nutrient Intake in Patients with Gestational Diabetes Mellitus and Influencing Factors

目的:通过调查妊娠糖尿病孕妇在孕中期能量及营养素的摄入量,探讨孕期膳食结构、孕前体重、孕期体重增长等对妊娠期糖尿病发病的影响,为进一步针对孕期营养指导和干预提供科学依据。方法:选取北京友谊医院营养门诊就诊的170例妊娠糖尿病患者作为调查对象,使用24 h膳食回顾调查法和食物频度法,分析其每天膳食中热能及营养素的摄入量,并将相关指标进行Pearson相关分析,探讨孕期膳食、孕前体重、体重增长情况对妊娠期糖尿病发病的影响。结果:患妊娠糖尿病孕妇孕中期每日膳食中水果与油脂类的摄入量高于推荐摄入量;每日总能量摄入略低,蛋白质供能比例为14.2%、脂肪供能比为33.9%;每日饮食中,除钾、维生素E的摄入量高于推荐量外,其他矿物元素和维生素的摄入量均偏低;孕期增重与孕期摄入的总能量成正相关(r=0.157,P<0.05),口服葡萄糖耐量试验(DGTT)2h血糖值与孕期摄入的总能量成正相关(r=0.2,P<0.05),与摄入的脂肪量成正相关(r=0.17,P<0.05),空腹血糖值与孕前体质指数成正相关(r=0.209,P<0.05)。结论:妊娠糖尿病患者在孕中期饮食结构不合理,脂肪摄入过多,妊娠期间应合理控制饮食,做到营养均衡合理,同时应加强妊娠期妇女的孕期营养健康教育及围产期保健,控制体重的合理增长,降低妊娠妊娠糖尿病的发病率,提高母婴健康水平。

[Objective] According to investigate the intake levels of energy and nutrients intake levels and weight gain of pregnant women diagnosed with gestational diabetes mellitus（ GDM） to explore the effects of pregnancy weight,diet and weight gain on the pathogenesis of GDM to provide scientific basis for nutritional guidance and intervention. [Method]Totally 170 cases of GDM women in out-patient clinic were enrolled. A questionnaire was used to review their nutritional status by using 24 h dietary recall survey and food frequency survey method to analyze the daily dietary intake of nutrients and energy compared with the recommended dietary intake of Chinese residents,so as to explore the effects of diet,pregnancy weight,weight gain on the influence of gestational diabetes. [Result]The daily intake of fruits and fats and oils was higher than RNI,the others could reach the recommended intake,total daily energy intake was slightly lower,three nutriments energize were unreasonable, the energize protein, fat and carbohydrate provided were 14. 2%,33. 9%,51. 9% respectively. Vitamin E and fiber levels were higher,other minerals and vitamin intake were lower; weight gained during pregnancy was positively correlated with total energy intake（ r = 0. 157,P〈0. 05）,the blood glucose concentration after 2 h of the glucose tolerance test was positively correlated with the total energy intake,（ r = 0. 2,P〈0. 05）,but negatively correlated with the fat intake（ r = 0. 17,P〈0. 05）,the fasting blood-glucose was positively correlated with BMI（ r = 0. 209,P〈0. 05）. [Conclusion]Diet structure of GDM women during pregnancy was irrational,limiting the intake of fat of the diet was important. Strictly taking control of preconception weight and strengthening the health of pregnant women＇s nutrition and perinatal health education might help to reduce the incidence of GDM and improve maternal and infant healthy.