低血糖指数谷物对妊娠糖尿病孕妇代谢组学及妊娠结局的影响

Effects of low glycemic index cereals on metabolomics and pregnancy outcomes of gestational diabetes pregnant women.

目的探究低血糖指数谷物对妊娠糖尿病孕妇代谢组学及妊娠结局的影响。方法前瞻性选取2018年1月至2019年12月同济大学附属第一妇婴保健院收治的60例妊娠糖尿病孕妇,按照随机数字表法将其分为两组:对照组和观察组,每组各30例。对照组孕妇给予每日总能量摄入控制,观察组孕妇在对照组基础上加用低血糖指数谷物治疗,将正常孕妇氢核磁共振波谱(H-NMR)图谱作为对照。对两组孕妇血清代谢组学予以H-NMR检测,比较两组孕妇的H-NMR图谱、生物标志物情况,随访两组的妊娠结局。结果将正常孕妇H-NMR图谱作为对照,观察组孕妇的H-NMR图谱与正常孕妇接近,但与对照组在相应保留时间方面差异显著;观察组孕妇极低密度脂蛋白、低密度脂蛋白、异亮氨酸、亮氨酸、缬氨酸、丙氨酸、N-乙酰糖蛋白、谷氨酸、O-乙酰糖蛋白、不饱和脂肪酸归一化后峰面积分别为235.28±43.23、492.48±93.23、19.03±3.15、16.10±2.31、13.92±3.04、33.66±4.72、91.68±9.78、16.95±2.23、18.93±4.12、59.06±7.13,对照组分别为290.37±31.34、640.19±80.34、16.03±3.08、13.36±2.31、10.28±2.43、26.84±6.45、81.36±7.31、14.02±1.42、13.87±2.21、67.38±6.52,两组比较差异均具有统计学意义(t=5.326,13.165,4.257,3.046,6.447,7.824,8.214,5.457,10.293,6.593,P<0.05);观察组孕妇的剖宫产率、并发症发生率分别为23.3%、10.0%,低于对照组的56.7%、26.7%,差异均具有统计学意义(χ2=14.224、6.568,P<0.05);观察组新生儿并发症发生率为13.3%,低于对照组的30.0%,差异具有统计学意义(χ2=5.736,P<0.05)。结论低血糖指数谷物在妊娠糖尿病孕妇中的应用,能够对孕妇代谢组学起到调节作用,改善妊娠结局,减少并发症的发生,值得临床推广。

Objective To explore the effect of Low glycemic index cereals on metabonomics and pregnancy outcome of pregnant women with gestational diabetes mellitus.Methods 60 pregnant women with gestational diabetes who were admitted to the First Maternity and Infant Hospital of Tongji University from January 2018 to December 2019 were randomly selected,and divided into two groups according to the random number table method:control group and observation group,each group with 30 cases.The pregnant women in the control group were given daily total energy intake control.The pregnant women in the observation group were treated with low-glycemic index cereals on the basis of the control group.Serum metabolomics of the two groups of pregnant women were tested by H-NMR spectroscopy(H-NMR method).The H-NMR spectra and biomarkers of the two groups of pregnant women were compared.The pregnancy outcomes of the two groups were followed up.Results The H-NMR spectrum of normal pregnant women was used as a control.The H-NMR spectrum of pregnant women in the observation group was close to that of normal pregnant women,but there was a significant difference in retention time from the control group.The pregnant women in the observation group had very low density lipoprotein,low density lipoprotein,and heterogeneity the normalized peak areas of leucine,leucine,valine,alanine,N-acetyl glycoprotein,glutamic acid,O-acetyl glycoprotein,and unsaturated fatty acids are 235.28±43.23,492.48±93.23,19.03±3.15,16.10±2.31,13.92±3.04,33.66±4.72,91.68±9.78,16.95±2.23,18.93±4.12,59.06±7.13,the control group is 290.37±31.34,640.19±80.34,16.03±3.08,13.36±2.31,10.28±2.43,26.84±6.45,81.36±7.31,14.02±1.42,13.87±2.21,67.38±6.52,the difference between the two groups is statistically significant(t=5.326,13.165,4.257,3.046,6.447,7.824,8.214,5.457,10.293,6.593,P<0.05);the cesarean section rate and complication rate of pregnant women in the observation group were 23.3%and 10.0%,respectively,lower than those in the control group 56.7%and 26.7%,the differences were statistically significant(χ2=14.224,6.568,P<0.05);the incidence of neonatal complications in the observation group was 13.3%,lower than 30.0%in the control group,the difference was statistically significant(χ2=5.736,P<0.05).Conclusion The application of low glycemic index grain in pregnant women with gestational diabetes mellitus can regulate the metabonomics of pregnant women,improve the outcome of pregnancy and reduce the incidence of complications,which is worthy of clinical promotion.