医学营养疗法联合运动训练对妊娠期糖尿病患者血清脂联素、血清铁蛋白及妊娠结局的影响

Effect of medical nutrition therapy combined with exercise training on adiponectin and serum ferritin levels,pregnancy outcomes in patients with gestational diabetes mellitus

目的探讨医学营养疗法(MNT)联合运动训练对妊娠期糖尿病(GDM)患者血清脂联素、血清铁蛋白及妊娠结局的影响。方法选择GDM患者83例随机分为对照组42例和观察组41例。对照组患者由营养医师进行常规GDM饮食指导,观察组患者采用MNT联合运动训练进行治疗,对两组患者血糖水平、胰岛细胞功能、血清脂联素、血清铁蛋白水平及妊娠结局进行分析。结果治疗后观察组患者空腹血糖、餐后2 h血糖水平显著低于对照组患者,糖化血红蛋白水平显著高于对照组患者,胰岛素抵抗指数显著低于对照组患者,胰岛β细胞分泌功能指数显著高于对照组患者,血清铁蛋白水平显著低于对照组患者,血清脂联素水平显著高于对照组患者,两组差异均有统计学意义(P<0.05)。观察组患者子痫前期、羊水过多、早产、巨大儿、产后出血、剖宫产、伤口感染以及新生儿呼吸窘迫综合征等不良妊娠结局发生率显著低于对照组患者,差异有统计学意义(P<0.05)。结论 MNT联合运动训练能够显著降低GDM患者血清铁蛋白水平,升高血清脂联素水平,有效控制GDM患者血糖水平,改善妊娠结局,具有较好的临床应用前景。

Objective To explore the effect of medical nutrition therapy（ MNT） combined with exercise training on adiponectin and serum ferritin levels,pregnancy outcomes in patients with gestational diabetes mellitus（ GDM）. Methods Eighty-three GDM patients were randomly divided into control group（ 42 patients） and observation group（ 41 patients）. The patients in control group received conventional dietary guidance established by nutritional doctors,while the patients in observation group were treated by MNT combined with exercise training. The levels of blood glucose,pancreatic cell function,adiponectin and serum ferritin levels,pregnancy outcomes in the two groups were analyzed. Results After treatment,the levels of fasting blood glucose,2-hour postprandial blood glucose,insulin resistance index,and serum ferritin in observation group were statistically significantly lower than those in control group（ P〈0. 05）. The levels of glycosylated hemoglobin,HOMA β-cell function index（ HBCI）,and adiponectin in observation group were statistically significantly higher than those in control group（ P〈0. 05）. The incidence rates of adverse pregnancy outcomes（ preeclampsia,polyhydramnios,preterm birth,macrosomia,postpartum hemorrhage,cesarean section,wound infection,and neonatal respiratory distress syndrome） in observation group were statistically significantly lower than those in control group（ P〈0. 05）. Conclusion MNT combined with exercise training can significantly reduce serum ferritin levels of the patients,increase serum adiponectin levels,control blood glucose level effectively,and improve pregnancy outcomes,which has good prospects for clinical application.