孕期微量营养素摄入与妊娠期糖尿病患者血糖控制效果的相关性研究

Study on the correlation between micronutrient intake during pregnancy and glycemic control outcomes in patients with gestational diabetes

目的分析孕期微量营养素摄入与妊娠期糖尿病(GDM)患者血糖控制效果的相关性,为临床微量营养素的补充提供依据。方法于2020年5月—2023年1月选择新昌县人民医院定期进行产前检查的100名GDM患者及同期产检血糖正常的100名孕妇为对照组进行研究(妊娠均为27~35周),通过问卷调查、24 h膳食回顾法获得研究对象的基本信息和膳食摄入状况。采用二元logistic回归分析研究微量营养素摄入对GDM孕妇血糖控制效果的影响。结果与对照组比较,GDM组的膳食总能量、蛋白质及脂肪摄入量分别为(2217.65±156.09)kcal、(97.24±11.42)g、(66.23±7.83)g,均高于对照组[(2163.44±113.24)kcal、(86.43±9.82)g、(61.77±6.33)g,均P<0.05];二元logistic回归分析显示,高蛋白质、高脂肪、低碳水化合物供能比是GDM孕妇血糖控制的危险因素(OR=2.462、2.533、2.126,P<0.05);维生素A、维生素B1、维生素B2、维生素B6、维生素D、维生素E、锌、铁、铜、硒是GDM孕妇血糖控制的保护因素(OR=0.451、0.237、0.184、0.760、0.228、0.081、0.871、0.311、0.073、0.105,P<0.05)。结论GDM孕妇蛋白质及脂肪摄入过多、碳水化合物摄入过少。微量营养素摄入增加与GDM孕妇血糖控制较好有关,临床应重视微量营养素的补充,降低妊娠期糖尿病的发生。

Objective To analyze the correlation between micronutrients intake during pregnancy and the effect of blood glucose control in patients with gestational diabetes(GDM),and to provide a basis for clinical supplementation of micronutrients.Methods From May 2020 to January 2023,100 GDM patients who underwent regular prenatal examinations at Xinchang People's Hospital and 100 pregnant women with normal blood glucose levels during the same period of prenatal examination were selected as the GDM group and the control group for the study(all were 27 to 35 weeks of gestation).Basic information and dietary intake status of the study subjects were obtained through questionnaire surveys and 24-hour dietary review methods.Binary logistic regression analysis was used to investigate the effect of micronutrient intake on blood glucose control in GDM pregnant women.Results Compared with the control group,the total dietary energy,protein,and fat intake of the GDM group were(2217.65±156.09)kcal,(97.24±11.42)g,and(66.23±7.83)g,respectively,which were higher than those in the control group[(2163.44±113.24)kcal,(86.43±9.82)g,(61.77±6.33)g,all P<0.05];Binary logistic regression showed that high protein,high fat and low carbohydrate energy supply ratio were risk factors for blood glucose control in GDM pregnant women(OR=2.462,2.533,2.126,P<0.05);Vitamin A,vitamin B 1,vitamin B 2,vitamin B 6,vitamin D,vitamin E,zinc,iron,copper,and selenium were protective factors for glycemic control in pregnant women with GDM(OR=0.451,0.237,0.184,0.760,0.228,0.081,0.871,0.311,0.073,0.105,P<0.05).Conclusion The diet structure of GDM pregnant women is unreasonable,the intake of protein and fat is too high,and the intake of carbohydrate is too low.Increased micronutrient intake is associated with better control of blood glucose in GDM pregnant women.clinical emphasis should be placed on micronutrient supplementation to reduce the incidence of gestational diabetes.