MNT治疗联合二甲双胍对妊娠期糖尿病患者糖脂代谢及血清ADP、ApoM的影响

Effects of MNT therapy combined with metformin on glycolipid metabolism and serum ADP and Apo M in patients with gestational diabetes

目的:观察医学营养疗法(Medical nutrition therapy,MNT)治疗联合二甲双胍对妊娠期糖尿病(Gestational diabetes mellitus,GDM)患者糖脂代谢及血清脂联素(ADP)、载脂蛋白M(Apo lipoprotein M,Apo M)的影响。方法:2021年4月~2023年4月我院收治的192例GDM患者,根据随机数字表法分为观察组(n=96)、对照组(n=96)。对照组给予二甲双胍,观察组给予MNT联合二甲双胍。对比2组治疗效果、糖脂代谢指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)]、病情相关指标[同型半胱氨酸(Hcy)、瘦素、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]及血清ADP、Apo M水平。结果:观察组治疗总有效率97.92%高于对照组88.54%(P<0.05)。FBG、2 hPG、HbA1c、TC、TG、LDL-C水平及血清Hcy、CRP、瘦素、TNF-α水平比较:治疗后<治疗前,且观察组<对照组。HDL-C水平及血清ADP、Apo M水平比较:治疗后>治疗前,且观察组>对照组(P<0.05)。结论:MNT联合二甲双胍可调节GDM患者血清ADP、Apo M水平,影响糖脂代谢,有效控制血糖,可作为提高GDM临床疗效的有效治疗方式。

Objective:To observe the effects of medical nutrition therapy(MNT)combined with metformin on glucose and lipid metabolism and serum adiponectin(ADP)and Apo lipoprotein M(Apo M)in patients with gestational diabetes mellitus(GDM).Methods:192 patients with GDM admitted to our hospital from April 2021 to April 2023 were divided into observation group(n=96)and control group(n=96)according to random number table method.Control group was given metformin,observation group was given MNT combined with metformin.The therapeutic effect,glucose and lipid metabolism indexes[fasting blood glucose(FBG)and 2h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),high density Lipoprotein cholesterol(HDL-C),disease-related indicators[homocysteine(Hcy),leptin,C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]]and serum ADP,Apo M levels were compared between the two groups.Results:The total effective rate of observation group was 97.92%higher than that of control group 88.54%(P<0.05).The levels of FBG,2 hPG,HbA1c,TC,TG,LDL-C and serum Hcy,CRP,leptin,TNF-αwere compared after treatment<before treatment,and observation group<control group.The levels of HDL-C and serum ADP and Apo M were compared after treatment>before treatment,and observation group>control group(P<0.05).Conclusion:MNT combined with metformin can regulate serum ADP and Apo M levels in patients with GDM,affect glucose and lipid metabolism,and effectively control blood sugar,which can be used as an effective treatment to improve the clinical efficacy of GDM.