膳食调整单不饱和脂肪酸对妊娠糖尿病患者脂糖代谢及母婴结局的影响

Effect of dietary adjusted monounsaturated fatty acids on the lipid glucose metabolism and maternal and infant outcome in patients with gestational diabetes mellitus

目的探讨膳食调整单不饱和脂肪酸(monounsaturated fatty acids,MUFA)对妊娠糖尿病(gestational diabetes mellitus,GDM)患者脂糖代谢及母婴结局的影响。方法选取2017年1月至2018年1月本院收治的GDM患者200例,依据随机数字表法分为MUFA组和常规组,每组100例,常规组给予常规膳食干预,MUFA组在此基础上给予膳食调整MUFA干预,比较2组膳食营养、血糖、血脂、母婴结局。结果 MUFA组和常规组干预后脂肪及其供能比、MUFA及其供能比明显低于干预前,MUFA组脂肪及其供能比、MUFA及其供能比明显高于常规组,差异有统计学意义(P<0.05);MUFA组和常规组干预后空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2 hPBG)、糖基化血红蛋白(glycosylation hemoglobin,HbA1c)、三酰甘油(three acylglycerol,TG)、胆固醇(cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL-C)、高密度脂蛋白(high density lipoprotein,HDL-C)明显低于干预前,MUFA组干预后FBG、2hPBG、HbA1c、TG、TC、LDL-C明显低于常规组,MUFA组干预后HDL-C明显高于常规组,差异有统计学意义(P<0.05);MUFA组不良母婴结局发生率明显低于常规组,差异有统计学意义(P<0.05)。结论膳食调整MUFA可有效改善GDM患者膳食营养、脂糖代谢紊乱状态,有利于改善患者的母婴结局,值得临床作进一步推广。

Objective To explore the effect of dietary adjusted monounsaturated fatty acids（MUFA） on the lipid glucose metabolism and maternal and infant outcome in patients with gestational diabetes mellitus（GDM）. Methods A total of 200 patients with GDM were selected from January 2017 to January 2018 in our hospital, according to the random number table method, they were divided into the MUFA group and the routine group, with 100 cases in each group. The routine group was given routine dietary intervention, and MUFA group was given dietary adjusted MUFA intervention on the basis. The dietary nutrition, blood sugar, blood lipid, maternal and infant outcome were compared between the 2 groups. Results The fat and functional ratio, MUFA and functional ratio of the MUFA group were significantly lower than those before the intervention. The fat and its functional ratio, MUFA and its functional ratio in the MUFA group were significantly higher than those in the routine group, and the differences were statistically significant（P〈0.05）. Fasting glucose, fasting blood glucose（FBG）, 2 h postprandial blood glucose（2 hPBG）, glycosylation hemoglobin（HbA1 c）, three acylglycerin（TG）, cholesterol（TC）, low density lipoprotein（LDL-C） and high density lipoprotein（HDL-C） of MUFA group and routine group after intervention were significantly lower than before the intervention. After intervention, FBG, 2 hPBG, HbA1 c, TG, TC and LDL-C of the MUFA group were significantly lower than those of the routine group. After MUFA intervention, HDL-C was significantly higher than that of routine group, and the difference was statistically significant（P〈0.05）. The incidences of adverse maternal and infant outcomes in the MUFA group were significantly lower than those in the conventional group, and the differences were statistically significant（P〈0.05）. Conclusions Dietary adjusted MUFA can effectively improve the dietary nutrition, lipid and glucose metabolism disorder state in patients with GDM, and it is helpful to improve maternal and neonatal outcome in patients, which is worth for further clinical promotion.