Validation of adherence prediction system for lifestyle interventions in nonalcoholic fatty liver disease

This editorial delves into the research article by Zeng et al published in the latest issue of World Journal of Gastroenterology.The manuscript contributes significantly to addressing the global health issue of nonalcoholic fatty liver disease(NAFLD)by introducing and validating the Exercise and Diet Adherence Scale(EDAS).The article effectively conveys the importance of the study,highlighting the prevalence of NAFLD,the lack of approved drugs for its treatment,and the crucial role of lifestyle correction.The use of the Delphi method for scale development and the subsequent evaluation of its reliability add scientific rigor to the methodology.The results demonstrate that the scale is correlated with key lifestyle indicators,which makes it a promising tool for assessing patient adherence to interventions.The identification of specific score thresholds for predicting adherence to daily calorie intake and exercise adds practical value to the scale.The differentiation among scores indicative of good,average,and poor adherence enhances its clinical applicability.In conclusion,the manuscript introduces EDAS,a valuable instrument that can contribute substantially to the field of NAFLD research and clinical practice.

Management of gestational diabetes mellitus via nutritional interventions:The relevance of gastric emptying

Gestational diabetes mellitus(GDM)represents one of the most common medical complications of pregnancy and is important to the well-being of both mothers and offspring in the short and long term.Lifestyle intervention remains the mainstay for the management of GDM.The efficacy of nutritional approaches(e.g.calorie restriction and small frequent meals)to improving the maternal-neonatal outcomes of GDM was attested to by Chinese population data,discussed in two articles in recent issues of this journal.However,a specific focus on the relevance of postprandial glycaemic control was lacking.Postprandial rather than fasting hyperglycaemia often represents the predominant manifestation of disordered glucose homeostasis in Chinese women with GDM.There is now increasing appreciation that the rate of gastric emptying,which controls the delivery of nutrients for digestion and absorption in the small intestine,is a key determinant of postprandial glycaemia in both health,type 1 and 2 diabetes.It remains to be established whether gastric emptying is abnormally rapid in GDM,particularly among Chinese women,thus contributing to a predisposition to postprandial hyperglycaemia,and if so,how this influences the therapeutic response to nutritional interventions.It is essential that we understand the role of gastric emptying in the regulation of postprandial glycaemia during pregnancy and the potential for its modulation by nutritional strategies in order to improve postprandial glycaemic control in GDM.

Cancer metabolism and dietary interventions

Metabolic remodeling is a key feature of cancer development.Knowledge of cancer metabolism has greatly expanded since the first observation of abnormal metabolism in cancer cells,the so-called Warburg effect.Malignant cells tend to modify cellular metabolism to favor specialized fermentation over the aerobic respiration usually used by most normal cells.Thus,targeted cancer therapies based on reprogramming nutrient or metabolite metabolism have received substantial attention both conceptually and in clinical practice.In particular,the management of nutrient availability is becoming more attractive in cancer treatment.In this review,we discuss recent findings on tumor metabolism and potential dietary interventions based on the specific characteristics of tumor metabolism.First,we present a comprehensive overview of changes in macronutrient metabolism.Carbohydrates,amino acids,and lipids,are rewired in the cancer microenvironment individually or systematically.Second,we summarize recent progress in cancer interventions applying different types of diets and specific nutrient restrictions in pre-clinical research or clinical trials.

Effect of enteral and parenteral nutritional diet intervention on recovery, nutritional status and immune functi on for gastric cancer patients after radical gastrectomy

Objective:To explore the effect of enteral and parenteral nutritional diet intervention on recovery, nutritional status and immune function for gastric cancer patients after radical gastrectomy.Methods:A total of 180 patients with gastric cancer treated in our hospital from January 2016 to December 2017 were selected, and randomly divided into the control group and the observation group by computer, each with 90 cases. Control group received parenteral nutrition intervention, and observation group received enteral and parenteral nutritional diet intervention. Cellular immune function, humoral immune function, nutritional status, and complications occurrence rate were compared between two groups.Results: The levels of cellular immune function between the two groups had no difference before intervention (P>0.05). After intervention, the observation group had higher levels of CD3+, CD4+, and CD4+/CD8+ as well as lower level of CD8+ than those of control group (P<0.05). The IgM, IgA, and IgG levels between the two groups had no difference before treatment (P>0.05), which were decreased after treatment (P<0.05), and were lower in the observation group than those in the control group (P<0.05). The albumin and prealbumin levels between the two groups had no difference before intervention (P>0.05), which were increased after treatment, and were higher in observation group than those in the control group (P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05).Conclusion:The application of enteral and parenteral nutritional diet intervention can promote the recovery, improve the nutritional status and immune function for gastric cancer patients after radical gastrectomy, which has fewer complications.

Diet restriction and exercise alleviate cognitive reduction of high fat diet (HFD)-induced obese mice by rescuing inflammation-mediated compromised insulin signaling pathway through activating AMPK/SIRT1 signal pathway and suppressing TLR4 signal pathway

Obesity,caused by excessive energy,leads to body weight gain and various diseases,including cognitive impairment.Current studies suggest that diet restriction such as optimal fasting and regular exercise are crucial for improving cognitive capacity.However,further exploration is needed to understand the specific mechanisms of high fat diet(HFD)-induced cognitive decline in obesity.In the present study,4-month-old mice were subjected to HFD feeding for 18 weeks,followed by aerobic exercise and high-intensity intermittent exercise,regular diet feeding,and intermittent fasting for 8 weeks,and then used to evaluate cognitive capacity,inflammation,compromised insulin signaling pathway,and apoptosis in hippocampal tissue,as well as AMPK/SIRT1 and TLR4 signal pathways.Obese mice revealed impaired cognitive capacity as compared with mice fed with regular diets.In contrast,aerobic exercise,high-intensity intermittent exercise,regular diet,and intermittent fasting could inhibit apoptosis caused by inflammation-mediated compromised insulin signaling pathway in hippocampal tissues through activating the AMPK/SIRT1 signal pathway and suppressing the TLR4 signal pathway,thereby rescuing the cognitive impairment of obese mice.Therefore,diet restriction and exercise interventions may play a positive role in reverting obesity-induced cognitive impairment.

A Theory-Based Dietary Intervention for Overweight, Postpartum Mothers and Their Children Improves Maternal Vegetable Intake

Objective: To evaluate the effectiveness of a dietary intervention to increase target vegetable intake in overweight, postpartum mothers;and their children. Methods: Overweight mothers attending their six-week postpartum follow-up visit and their infants (n = 104 pairs) were randomized to intervention or usual care groups during the time period 2008-2011. Mothers received four 60 minute education sessions with a nutrition professional and eight monthly follow-up phone calls. Counseling began at the obstetrician office and continued at the regularly scheduled pediatric visits. The primary study outcome was the change in maternal target vegetable intake. Secondary outcomes included child target vegetable intake and whether child vegetable intake was modified by exposure to breastfeeding. Mother/child energy intake and weight indices were also assessed. Outcomes were measured at baseline (6-weeks postpartum), 6, 12 (post-intervention), and 18 (follow-up) months. Mixed-effects models were used to estimate the impact of the dietary intervention on study outcomes relative to usual care. Results: Mothers randomized to the intervention had greater consumption of target vegetables at 6, 12 and 18 months (P P P = 0.03, respectively). There were no differences between groups in maternal energy intake, body mass index, or child target vegetable or energy intake. The child’s target vegetable intake at 12 months was related to the mother’s intake at 6 months (P = 0.03), however, this relationship was not modified by exposure to breastfeeding. Conclusion: A dietary intervention targeting the diet of the mother/child dyad resulted in improved maternal vegetable intake.

母鼠高脂饮食与运动干预对雄性子代胰岛素敏感性及下丘脑弓状核的影响

背景:肥胖母体的子代,有些代谢基因在某些环境影响下处于“沉默”状态,这些“沉默”的基因可能因后天环境的影响又被“唤醒”,继而引起代谢调控紊乱。目的:雄性子代在不同饮食结构的情况下,探索母鼠长期高脂和运动干预的代谢遗传效应。方法:3周龄雌性C57BL/6小鼠70只,随机分成高脂安静组与高脂运动组,干预16周后自然分娩。2组在4周哺乳期结束后,各随机抽取子代雄性小鼠16只,共32只分为4组:高脂安静-高脂组、高脂运动-高脂组、高脂安静-普食组、高脂运动-普食组,分别给予6周高脂喂养或普食喂养。子代在第10周进行葡萄糖耐量试验与胰岛素耐量试验,随后进行体成分分析及取材。肝脏蛋白免疫印迹测定p-Akt水平;下丘脑弓状核免疫荧光分析神经肽Y和阿黑皮素的表达情况。结果与结论:①在高脂饮食模式下,与高脂安静组相比,高脂运动组子代小鼠的糖代谢能力、体质量、体成分等都有显著性改善(P<0.05);②在普食饮食模式下,与高脂安静组相比,高脂运动组子代小鼠下丘脑弓状核的神经肽Y表达量显著下降(P<0.05),阿黑皮素表达显著上调(P<0.05),肝脏Akt(Ser473)磷酸化蛋白表达在胰岛素(-)的情况下无显著性差异,但在胰岛素(+)的情况下组间差异有显著性意义(P<0.05);③结果说明,子代在高脂模式下,母体长期运动获得的代谢保护效应可能会随着子代高脂暴露时间的延长而逐渐弱化;子代在普食模式下,母代长期的运动可以改善雄性子代能量代谢的中枢调控和胰岛素的敏感性。

颅咽管瘤相关下丘脑性肥胖危险因素及饮食运动干预研究进展

颅咽管瘤相关下丘脑性肥胖已成为颅咽管瘤患者术后管理中的重要问题。有研究指出通过调整热量摄入、制订并实施运动计划能显著降低颅咽管瘤相关下丘脑性肥胖患者体质量,可将非药物治疗措施如饮食运动干预应用于颅咽管瘤患者的体质量管理中,但目前国内相关研究较少。因此,本文综述了颅咽管瘤相关下丘脑性肥胖现状、危害、危险因素和饮食运动干预策略,以期改善疾病预后、提高生存质量。建议临床医护人员应重视颅咽管瘤患者相关下丘脑性肥胖,开展颅咽管瘤相关下丘脑性肥胖患者体质量控制的前瞻性研究,并构建科学严谨的饮食运动干预方案,为全面提高颅咽管瘤患者的生存质量提供参考。

PDCA循环在胃癌术后化疗病人营养干预中的应用

目的:探讨PDCA循环在胃癌术后化疗病人营养干预中的应用效果。方法:采用便利抽样法,选取2022年3月—11月在山西省某三级甲等医院肿瘤科行术后化疗的胃癌病人为研究对象,按照初次入院所在病区分为对照组(45例)和观察组(45例)。对照组接受常规营养支持,观察组由多学科营养干预团队进行基于PDCA循环的营养干预。比较两组病人饮食依从率、营养支持达标率、营养不良发生情况、外周血营养指标、生活质量。结果:对照组和观察组各有3例病人脱落,最终对照组和观察组各有42例病人完成研究。干预后,观察组饮食依从率为92.86%,高于对照组依从率(47.62%);观察组营养支持达标率为88.10%,高于对照组达标率(38.10%);观察组营养状况好于对照组;观察组总蛋白、白蛋白、血清前白蛋白水平均高于对照组;观察组总体健康状况和躯体、情绪、认知、角色、社会5个功能领域的评分均高于对照组,疲劳、恶心与呕吐、失眠、食欲减退、便秘、腹泻症状评分低于对照组,差异均有统计学意义(P<0.05)。结论:基于PDCA循环的营养干预能够提高胃癌术后化疗病人的饮食依从性,改善病人营养状况,提高病人生活质量。

孕早期营养干预结合中医体质辩证预防高风险妊娠期糖尿病孕妇的不良妊娠结局

目的:评估营养干预结合中医体质辩证对孕早期高风险孕妇妊娠期糖尿病(GDM)的发生、孕期膳食质量及母婴结局的影响。方法:选择2022年12月1日至2023年3月30日在乌鲁木齐市妇幼保健院产科建档的孕早期(孕周≤14周)GDM高风险孕妇298例为研究对象,随机分为干预组(149例)和对照组(149例)。在孕14~23^(+6)周,对干预组孕妇进行中医体质化营养干预,对照组进行常规指导和健康饮食宣教。比较两组在孕24~28周GDM的发生率,采用Logistic回归法和似然比检验对孕早期营养干预结合中医体质与GDM风险之间关系进行亚组分析;比较两组在孕32~36周,干预后的膳食情况、生化指标和分娩结局。结果:①干预组GDM的发生率明显低于对照组(14.09%vs.23.49%,P<0.05),中医体质化营养干预的方式对GDM风险概率的影响仅在孕期体质量增加(GWG)不同范围的孕妇中差异有统计学意义(P=0.018),其中GWG低于建议范围内的孕妇,干预降低了GDM的发生风险(OR 0.27,95%CI 0.10~0.68,P=0.008)。②干预后,干预组孕妇膳食平衡指数评价指标优于对照组(P<0.05),干预组孕晚期孕妇在谷薯类、蔬菜、饮水量摄入方面高于对照组(P<0.05)。③干预组孕妇孕晚期甘油三酯、总胆固醇、低密度脂蛋白、糖化血红蛋白、尿酸和肌酐水平均低于对照组(P<0.05),GWG、分娩孕周、低出生体质量儿率、新生儿1分钟Apgar评分均优于对照组(P<0.05)。结论:孕早期营养干预结合中医体质辨识,能够显著降低高风险孕妇GDM的发生和低出生体质量儿的几率,产科门诊可积极开展与中医科、临床营养科的广泛合作,以降低母胎的不良妊娠结局。

营养干预在乳腺癌预防治疗中的研究进展

对乳腺癌(breast cancer,BC)发病率和复发的饮食因素、BC治疗对女性营养状况的影响、BC治疗期间的营养干预以及降低BC复发和死亡率的营养干预进行综述,总结发现BC病人的营养干预可被视为多模式治疗方法的一个组成部分,为临床医护人员治疗乳腺癌提供相关依据。

等热量低碳水化合物高蛋白饮食对非酒精性脂肪性肝病血清脂质的影响

目的 研究等热量低碳水化合物高蛋白饮食(CRD)对非酒精性脂肪性肝病(NAFLD)患者的影响及形成的脂质代谢差异。方法 收集2019年1月—2022年6月在上海市普陀区中心医院消化内科诊断为NAFLD的患者25例与健康志愿者25例,NAFLD患者采用CRD干预。采集受试者基本信息,检测肝功能、血脂等生化指标,使用超高效液相色谱串联高分辨质谱(UPLC-Q-Orbitrap/MS)技术进行血清脂质分析。主成分分析(PCA)和正交偏最小二乘判别法(OPLS-DA)用于分析血清脂质代谢标志物。结果 经过4周的饮食干预后,患者的体质量由(77.88±10.76) kg降至(76.62±10.78) kg,(P<0.001)、体质指数(BMI)由25.63(24.40-26.80)kg/m^(2)降低至24.88(24.5-26.34)kg/m^(2)(P<0.01)、腰围无显著性变化(P>0.05)。CRD干预后NAFLD患者AKP水平[(3.12±23.90) U/L]显著低于干预前[(93.36±30.41) U/L],(P<0.01)。GGT、ALT水平分别由干预前的(43.84±27.78) U/L、35.0(25.0-76.5)U/L降低至(35.16±17.51) U/L和28.0(14.5-45.5)U/L(均P<0.05)。患者血清TC水平由4.56(3.82-6.31)mmol/L降低至3.15(1.79-4.32)mmol/L(P<0.001)。CHE、AST、TG、HDL、LDL水平无显著变化(均P>0.05)。脂质组学研究发现,CRD干预后,血清中OAFHA、LPC、MG、LPG、PI、PS、PG、PA和SM的含量发生显著变化(P<0.05)。结论 CRD干预可以减轻NAFLD患者体质量、降低BMI和腰围,改善患者肝功能和血脂异常。脂质组学分析表明,CRD饮食能缓解脂肪肝脂毒性、调控鞘脂代谢进而改善NAFLD的发生、发展。本次研究发现的53个脂质成分亦可作为NAFLD的生物标志物。

基于ADOPT问题解决模式的护理干预结合饮食疗法对糖尿病合并前列腺增生术后患者饮食行为及康复情况的影响

目的探讨基于ADOPT问题解决模式的护理干预结合饮食疗法对糖尿病合并前列腺增生术后患者饮食行为及康复情况的影响。方法选取2020年3月至2022年4月收治的86例糖尿病合并前列腺增生术后患者为研究对象,以随机数字表法将其分为对照组与观察组,各43例。对照组采用常规护理干预,观察组在对照组基础上给予基于ADOPT问题解决模式的护理干预结合饮食疗法。比较两组的干预效果。结果干预后,观察组的遵医饮食行为、日常饮食管理行为、饮食依从性态度评分高于对照组(P<0.05)。干预后,观察组的空腹血糖(FBG)、餐后2 h血糖(2 h PG)、CD68、碱性成纤维细胞生长因子(bFGF)水平低于对照组(P<0.05)。观察组的术后并发症总发生率低于对照组(P<0.05)。结论基于ADOPT问题解决模式的护理干预联合饮食疗法不仅能够改善糖尿病合并前列腺增生术后患者的饮食行为,还能促进机体康复,减少术后并发症发生风险,值得推广。

Management of non-alcoholic fatty liver disease:Lifestyle changes

In this editorial,we commented on a recently released manuscript by Zeng et al in the World Journal of Gastroenterology.We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease(NAFLD).NAFLD is a hepatic manifestation of the metabolic syndrome,which ultimately leads to advanced hepatic fibrosis,cirrhosis,and hepatocellular carcinoma and affects more than 25%of the population globally.Existing therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection,anti-inflammation,and regulating disease-related metabolic disorder symptoms.Although several drugs are in late-stage development,potent drugs against the diseases are lacking.Additionally,existing surgical approaches such as bariatric surgery are not routinely used to treat NAFLD.Intervening in patients’unhealthy lifestyles,such as weight loss through dietary changes and exercises to ameliorate patientassociated metabolic disorders and metabolic syndrome,is the first-line treatment for patients with NAFLD.With sufficient intrinsic motivation and adherence,the management of unhealthy lifestyles can reduce the severity of the disease,improve the quality of life,and increase the survival expectancy of patients with NAFLD.

综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇的效果

目的观察综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇的效果及对妊娠结局的影响效果。方法选取2021年7月至2022年6月收治于宿迁市第一人民医院的高龄妊娠期糖尿病患者90例为研究对象。采用随机数字表法将90例高龄妊娠期糖尿病患者分为试验组和对照组,每组45例。对照组遵循妊娠期糖尿病常规宣教法施护,试验组在此基础之上引入综合性早期饮食宣教指导干预机制,对2组干预后的各观察指标进行比较。结果试验组高龄妊娠期糖尿病患者饮食控制认知度评分、饮食控制依从性评分与对照组比较,差异均有统计学意义(P<0.05),试验组血糖控制成效测评指标优于对照组,不良妊娠结局率低于对照组(P<0.05)。结论采用综合性早期饮食宣教指导对高龄妊娠期糖尿病孕产妇施加干预,利于其饮食控制认知度、依从度的提升,可取得较佳血糖控制成效、减低不良妊娠结局概率。

行为改变理论构建中年急性胰腺炎患者阶梯式饮食干预策略及应用

目的 通过行为改变理论构建阶梯式饮食干预策略,并探讨其在中年急性胰腺炎患者中的应用效果。方法 采用前瞻性随机对照研究,选择2020年5月至2022年5月北京友谊医院感染内科收治的80例中年急性胰腺炎患者作为研究对象,经随机数字表法分为对照组与观察组,每组40例。对照组采用阶梯式饮食干预策略,观察组采用行为改变理论构建的阶梯式饮食干预策略。比较2组护理前后的营养指标[血清总蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)]、健康行为[健康促进生活方式量表-Ⅱ(HPLP-Ⅱ评分)]、生活质量[生活质量评价量表(SF-36评分)]以及护理满意度。结果 观察组患者护理后TP、ALB、Hb均显著高于同期对照组(P<0.05);与对照组比较,观察组患者遵医嘱、自我监测、定期复查、控制饮食的占比更高(P<0.05)。观察组患者护理后HPLP-Ⅱ评分显著高于同期对照组(P<0.05);观察组患者护理后SF-36评分、ADL评分显著高于同期对照组(P<0.05);与对照组比较,观察组患者不良事件发生率更低,护理满意度更高(P<0.05)。结论 中年急性胰腺炎患者采用行为改变理论构建的阶梯式饮食干预策略可以改善机体营养状态,提高自我管理、健康行为及生活质量水平,不良事件发生率更低,患者满意度更高。

Interplay of gut microbiota,glucagon-like peptide receptor agonists,and nutrition:New frontiers in metabolic dysfunction-associated steatotic liver disease therapy

The gut-liver axis plays a crucial role in the development and progression of metabolic dysfunction-associated steatotic liver disease(MASLD).Key metabolites,including lipopolysaccharides,short-chain fatty acids(SCFAs),bile acids,and beneficial gut bacteria such as Bifidobacterium and Lactobacillus,are pivotal in this process.Glucagon-like peptide-1 receptor agonists(GLP-1 RAs)show promise in managing MASLD by promoting weight loss,enhancing insulin secretion,and improving liver health.They restore gut-liver axis functionality,and their effects are amplified through dietary modifications and gut microbiometargeted therapies.Emerging research highlights the interplay between GLP-1 RAs and gut microbiota,indicating that the gut microbiome significantly influences therapeutic outcomes.Metabolites produced by gut bacteria,can stimulate glucagon-like peptide-1(GLP-1)secretion,further improving metabolic health.Integrating dietary interventions with GLP-1 RA treatment may enhance liver health by modulating the gut microbiota-SCFAs-GLP-1 pathway.Future research is needed to understand personalized effects,with prebiotics and probiotics offering treatment avenues for MASLD.

心理干预联合饮食护理对老年糖尿病外周神经病变患者的临床护理分析

目的 探讨在糖尿病外周神经病变老年患者护理中,展开心理干预联合饮食护理的价值。方法 选取2022年4月—2023年1月本院收治的80例糖尿病外周神经病变老年患者为研究对象,随机分为对照组和观察组,每组40例。其中,对照组应用常规护理服务,观察组应用心理干预联合饮食护理,分析两组心理状态、血糖水平、生活质量。结果 两组焦虑、抑郁评分对比,观察组低于对照组(P<0.05);两组血糖水平对比,观察组低于对照组(P<0.05);两组生活质量对比,观察组高于对照组(P<0.05)。结论 心理干预联合饮食护理的实施可改善老年糖尿病外周神经病变患者心理状态与生活质量,并将机体血糖水平控制在合理范围内,避免波动较大影响预后效果。

配偶同步的饮食联合运动干预对孕前超重合并妊娠糖尿病孕妇及其新生儿的影响

目的探讨配偶同步的饮食联合运动干预对孕前超重合并妊娠糖尿病(GDM)的孕妇及其新生儿的影响。方法将120例孕前超重合并GDM的孕妇根据妊娠期间配偶是否同步进行饮食联合运动干预,随机分为干预组(60例)和对照组(60例),孕妇均接受常规药物和胰岛素治疗,记录并比较2组孕妇初次产检时的年龄、体质量指数、空腹血糖(FPG)、餐后2 h血糖(2 h-PG)和糖化血红蛋白(HbA1c)水平,确诊为GDM和妊娠28周时的FPG、2 h-PG和HbA1c水平,分娩方式、分娩相关并发症(包括早产和产褥感染)发生率。采用抑郁自评量表(SDS)和焦虑自评量表(SAS)评估孕妇分娩后的情绪状态。比较2组新生儿体质量、血糖、新生儿并发症(包括巨大儿、低血糖、窒息)发生率、Apgar评分。结果2组比较,孕妇初次产检时的年龄、体质量指数、FPG、2 h-PG和HbA1c均无统计学差异(P>0.05)。妊娠28周时,2组孕妇的FPG、2 h-PG和HbA1c水平均较确诊为GDM时明显降低(P<0.05),且干预组上述3项指标均明显低于对照组(P<0.05)。分娩后2组比较,干预组自然分娩的比例明显高于对照组,分娩相关并发症的发生率明显低于对照组(均P<0.05)。干预组孕妇的焦虑和抑郁改善程度优于对照组(P<0.05)。干预组巨大儿数量和血糖水平低于对照组,Apgar评分高于对照组。结论配偶同步的饮食联合运动干预可以有效降低孕前超重合并GDM孕妇的血糖和HbA1c水平,并能有效降低分娩相关并发症和新生儿并发症的发生率,改善孕妇情绪状态。

妊娠期糖尿病孕妇的膳食情况及饮食指导对妊娠结局的影响

目的 探究妊娠期糖尿病孕妇膳食情况、血脂分布特征及饮食指导对妊娠结局的影响,为改善妊娠结局提供参考。方法 比较妊娠期糖尿病(GDM)孕妇(观察组,600例)和同期产检的健康孕妇(对照组,600例)的临床资料,利用24 h膳食回顾调查法分析两组的饮食摄入情况。观察组600例GDM孕妇依据意愿分为专业饮食指导组340例、自行调整饮食组260例,跟踪随访3组孕期的血脂水平变化情况及妊娠结局。结果 与对照组比较,观察组分娩前体质量、空腹血糖(FPG)、餐后2 h血糖(2 hFPG)水平高,脂肪、肉类、水果摄入量多,碳水化合物、蔬菜摄入量少,差异均有统计学意义(均P<0.05)。比较3组的孕中期甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平及孕晚期总胆固醇(TC)、TG、LDL-C水平,均为自行调整饮食组>专业饮食指导组>对照组;而高密度脂蛋白胆固醇(HDL-C)水平则为自行调整饮食组<专业饮食指导组<对照组,差异有统计学意义(均P<0.05)。自行调整饮食组不良妊娠结局发生率(18.46%)高于专业饮食指导组(6.18%)及对照组(1.50%),差异有统计学意义(χ^(2)=21.848,P<0.05)。结论 GDM孕妇的血脂水平在孕中、晚期明显上升,且膳食结构不合理,临床上建议通过饮食指导、健康干预纠正血脂代谢紊乱情况,继而改善妊娠结局。