孕中期妇女体力活动与血糖代谢的关联性

Association between physical activity and glucose metabolism in pregnant women

目的探究孕中期体力活动与血糖水平及妊娠期糖尿病(gestational diabetes mellitus,GDM)的关联。方法采用横断面调查的方法,于2017-2018年在广州市纳入孕周在20~28周的孕妇1083人。采用面对面调查收集一般人口学和生活方式等资料,采用国际体力活动问卷调查过去一周的体力活动,通过口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)测量孕妇血糖和诊断GDM。运用多重线性回归和Logistic回归分析模型分别探讨不同类型体力活动和静坐行为与血糖及GDM的关联。结果36.57%的孕妇体力活动达到推荐值(中高体力活动≥150 min/week)。多重线性回归结果表明,孕中期妇女总体力活动强度与OGTT-2 h血糖水平呈负相关关系(β=-0.10,P=0.017);运动锻炼和休闲体力活动强度与OGTT-1 h血糖呈负相关(β=-0.11,P=0.042),未发现其他类型体力活动或静坐时间与血糖之间的关联。Logistic回归分析模型分析未发现各类型体力活动或静坐时间与GDM风险之间的关联。结论孕中期妇女体力活动水平较低,近2/3妇女未达到推荐值。孕中期妇女总体力活动、运动锻炼和休闲体力活动有助于降低餐后血糖。

Objective To investigate the association between physical activity and glucose metabolism during the second trimester of pregnancy.Methods A cross-sectional study was conducted from March 2017 to November 2018.1083 pregnant women at 20-28 weeks of gestation in Guangzhou,China were recruited into this study.A standardized questionnaire was used to collect demographics and lifestyles.Physical activity was assessed by the international physical activity questionnaire.The participants underwent an oral glucose tolerance test.Multiple linear regression was used to analyze the association between physical activity and blood glucose.Logistic regression analysis model was used to analyze the association between physical activity and gestational diabetes mellitus(GDM).Results Only 36.57%of pregnant women met the recommended level of total physical activity.There was a negative correlation(β=-0.104,P=0.017)between total physical activity and postprandial 2 h blood glucose.Results from different types of physical activities showed that the recreation,sport,and leisure-time physical activity were negatively associated with postprandial 1 h blood glucose(β=-0.114,P=0.042).No significant association was found between either various types of physical activities or sedentary time and GDM.Conclusions Physical activity during mid-pregnancy is inadequate in pregnant women in Guangzhou,China.Higher total physical activity and recreation,sport,and leisure-time physical activity in the second trimester of pregnancy are associated with lower postprandial blood glucose.