目的依据中国膳食平衡指数(diet balance index16,DBI16)建立中国孕期膳食平衡指数(diet balance index for pregnancy,DBI-P)并评价广州市孕中期妇女膳食质量。方法在DBI16基础上,依据中国居民膳食营养素参考摄入量(2013)和中国妇幼人...目的依据中国膳食平衡指数(diet balance index16,DBI16)建立中国孕期膳食平衡指数(diet balance index for pregnancy,DBI-P)并评价广州市孕中期妇女膳食质量。方法在DBI16基础上,依据中国居民膳食营养素参考摄入量(2013)和中国妇幼人群膳食指南(2016),建立DBI-P。采用系统抽样的方法 ,于2017~2018年在广州市某区妇幼保健院纳入943名孕20~28 w的健康孕妇,采用经信效度检验的半定量膳食频率问卷以面对面的方式调查孕妇过去一个月的膳食摄入情况,应用DBI-P评价孕中期妇女膳食质量。结果孕中期妇女谷薯类、果蔬、奶类及大豆坚果类、鱼虾类、蛋类和饮水量存在一定比例的摄入不足,而畜禽肉类存在摄入过量;油盐和添加糖摄入适宜者(分值≤2)超过88%,97.56%孕妇孕期不饮酒。孕中期妇女膳食正端分均值为6.29,低中度摄入过量者比例为14.95%;负端分均值为24.67,低中度摄入不足者比例为83.25%;膳食质量距均值为30.96,低中度摄入不均衡者比例为90.14%。结论本研究所建立的DBI-P评分系统,可同时评价孕期膳食摄入过量和不足,适用于我国孕妇膳食质量的评估。广州市孕中期妇女膳食摄入不均衡,应加强孕期膳食健康教育与健康促进,改善孕妇营养状况。[营养学报,2020,42 (5):417-422]展开更多
Background Women with a history of gestational diabetes mellitus （GDM） are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose...Background Women with a history of gestational diabetes mellitus （GDM） are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose regulation （AGR） among Chinese women with a history of GDM. Methods A total of 186 women with a history of GDM were screened for early postpartum AGR at 6-8 weeks after delivery. Those with AGR were given lifestyle intervention therapy and reevaluated in 6-12 months. The demographic, anthropometric, prenatal and delivery data were recorded. The plasma high-sensitivity C-reactive protein （HsCRP） and lipid concentration were measured, and insulin secretion were analyzed. Insulinogenic index △ins30＇/△BG30＇, the homeostasis model assessment index （HOMA）-B, and HOMA-IR were calculated. Multiple regression analysis was performed to identify the risk factors. Results Of the GDM women 28.0% （52/186） had AGR at 6-8 weeks after delivery; 45.2% （17/40） of these AGR women reminded abnormal after 6-12 month lifestyle intervention. Compared to the women who reverted to normal, women with consistent AGR showed significantly lower fasting insulin concentration, lower △ins30＇/△BG30＇ as well as lower HOMA-B. No significant differences in age, body mass index （BMI）, waist circumference, blood pressure, lipid level HsCRP and HOMA-IR were observed between the two groups. Pre-pregnancy BMI ≥25 kg/m^2, fasting glucose level ≥5.6 mmol/L and/or 75 g oral glucose tolerance test （OGTT） 2 hours glucose level ≥11.1 mmol/L during pregnancy were predictors for the AGR at 6-8 weeks after delivery. △ins30＇/△BG30≤1.05 was a significant risk contributor to the consistent early postpartum AGR. Conclusion There is a high incidence of early postpartum AGR among Chinese woman with prior GDM. Beta-cell dysfunction, rather than insulin resistance or inflammation, is the predominant contributor to the early onset and consistent AGR after delivery.展开更多
文摘目的依据中国膳食平衡指数(diet balance index16,DBI16)建立中国孕期膳食平衡指数(diet balance index for pregnancy,DBI-P)并评价广州市孕中期妇女膳食质量。方法在DBI16基础上,依据中国居民膳食营养素参考摄入量(2013)和中国妇幼人群膳食指南(2016),建立DBI-P。采用系统抽样的方法 ,于2017~2018年在广州市某区妇幼保健院纳入943名孕20~28 w的健康孕妇,采用经信效度检验的半定量膳食频率问卷以面对面的方式调查孕妇过去一个月的膳食摄入情况,应用DBI-P评价孕中期妇女膳食质量。结果孕中期妇女谷薯类、果蔬、奶类及大豆坚果类、鱼虾类、蛋类和饮水量存在一定比例的摄入不足,而畜禽肉类存在摄入过量;油盐和添加糖摄入适宜者(分值≤2)超过88%,97.56%孕妇孕期不饮酒。孕中期妇女膳食正端分均值为6.29,低中度摄入过量者比例为14.95%;负端分均值为24.67,低中度摄入不足者比例为83.25%;膳食质量距均值为30.96,低中度摄入不均衡者比例为90.14%。结论本研究所建立的DBI-P评分系统,可同时评价孕期膳食摄入过量和不足,适用于我国孕妇膳食质量的评估。广州市孕中期妇女膳食摄入不均衡,应加强孕期膳食健康教育与健康促进,改善孕妇营养状况。[营养学报,2020,42 (5):417-422]
文摘Background Women with a history of gestational diabetes mellitus （GDM） are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose regulation （AGR） among Chinese women with a history of GDM. Methods A total of 186 women with a history of GDM were screened for early postpartum AGR at 6-8 weeks after delivery. Those with AGR were given lifestyle intervention therapy and reevaluated in 6-12 months. The demographic, anthropometric, prenatal and delivery data were recorded. The plasma high-sensitivity C-reactive protein （HsCRP） and lipid concentration were measured, and insulin secretion were analyzed. Insulinogenic index △ins30＇/△BG30＇, the homeostasis model assessment index （HOMA）-B, and HOMA-IR were calculated. Multiple regression analysis was performed to identify the risk factors. Results Of the GDM women 28.0% （52/186） had AGR at 6-8 weeks after delivery; 45.2% （17/40） of these AGR women reminded abnormal after 6-12 month lifestyle intervention. Compared to the women who reverted to normal, women with consistent AGR showed significantly lower fasting insulin concentration, lower △ins30＇/△BG30＇ as well as lower HOMA-B. No significant differences in age, body mass index （BMI）, waist circumference, blood pressure, lipid level HsCRP and HOMA-IR were observed between the two groups. Pre-pregnancy BMI ≥25 kg/m^2, fasting glucose level ≥5.6 mmol/L and/or 75 g oral glucose tolerance test （OGTT） 2 hours glucose level ≥11.1 mmol/L during pregnancy were predictors for the AGR at 6-8 weeks after delivery. △ins30＇/△BG30≤1.05 was a significant risk contributor to the consistent early postpartum AGR. Conclusion There is a high incidence of early postpartum AGR among Chinese woman with prior GDM. Beta-cell dysfunction, rather than insulin resistance or inflammation, is the predominant contributor to the early onset and consistent AGR after delivery.
