本文關鍵詞：妊娠期糖尿病與膳食攝入、紅細胞膜磷脂脂肪酸譜的相關性研究　出處：《寧夏醫(yī)科大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 妊娠期糖尿病 胰島素抵抗指數(shù) 空腹胰島素 不飽和脂肪酸

【摘要】：目的:本課題的目的是研究膳食攝入、紅細胞膜磷脂脂肪酸譜與妊娠期糖尿病(GDM)的關系。方法:2016.3~2016.9我們在濟寧市第一人民醫(yī)院征集了日常產(chǎn)檢并正常分娩的73名GDM孕晚期孕婦和74名健康孕晚期孕婦,分別作為病例組(GDM組)和對照組(NGT組),收集孕產(chǎn)婦的基本生理生化指標等參數(shù),記錄七天膳食攝入并采用氣相色譜儀檢測紅細胞膜磷脂脂肪酸譜,統(tǒng)計分析兩組孕產(chǎn)婦膳食、紅細胞膜磷脂脂肪酸譜差異,采用二分類非條件logistic回歸研究GDM發(fā)病的影響因素,通過偏相關分析探討GDM與膳食攝入、紅細胞膜磷脂脂肪酸譜之間的相關性。結(jié)果:1.GDM組與NGT組相比較,年齡、宮高、腹圍、孕周、孕前體重、產(chǎn)前體重、孕期增重、體質(zhì)指數(shù)(BMI)、胎兒體重、Apgar評分、尿酸(UA)、肌酐(Cr)、白蛋白(ALB)、胰島素抵抗指數(shù)(HOMA-IR)、空腹胰島素(FIns)指標差異均有統(tǒng)計學意義(P0.05);2.膳食攝入情況:GDM組蛋白攝入量顯著高于NGT組(108.50±19.21g vs.99.16±16.40 g)、GDM組脂肪攝入量顯著高于NGT組(103.53±21.99g vs.93.32±18.67 g)、GDM組碳水化合物攝入量顯著高于NGT組(357.03±51.80g vs.292.39±52.60g);GDM組膳食總能量顯著高于NGT組(2648.82 kcal vs.2305.42 kcal);GDM組VitB1、VitB2、VitC、VitPP、鉀、鈉、鎂、鐵、鋅、磷、蘇氨酸、谷糧能量、果類能量、肉類能量、蔬菜能量、蛋類能量顯著高于NGT組,而魚蝦能量NGT組顯著高于GDM組(90.19 kcal vs.37.73 kcal),差異均有統(tǒng)計學意義(P0.05);3.紅細胞膜磷脂脂肪酸譜:NGT組C16:0、C18:0、總飽和脂肪酸(SFA)、總n-6多不飽和脂肪酸(PUFA)/n-3 PUFA顯著高于GDM組,GDM組總單不飽和脂肪酸(MUFA)、總PUFA、總MUFA/SFA、C22:6n-3、C18:1n-9、C22:5n-3、C22:6n-3、n-3PUFAs顯著高于NGT組,差異均有統(tǒng)計學意義(P0.05);4.BMI≥24 Kg/m2(OR=2.874)、年齡≥30y(OR=3.638)、孕期增重≥12.5 kg(OR=9.201)是GDM危險因素,每周堅果食用≥50 g(OR=0.301)是GDM保護因素;5.空腹胰島素與C16:0、C20:3n-3、n-6/n-3 PUFAs、總能量、蛋白、碳水化合物、鉀、鎂、果類能量、豆類能量及其供能比之間成正相關,與C24:0、C22:6n-3、總LC-MUFA、n-3 PUFAs成負相關,差異均有統(tǒng)計學意義(P0.05);胰島素抵抗指數(shù)與總能量、蛋白、鉀、鈣、鎂、磷、豆類能量、C16:0、C20:3n-3、n-6/n-3 PUFAs成正相關,與C24:0、C20:1n-9、C22:5n-3、C22:6n-3、總PUFA、總長鏈單不飽和脂肪酸(LC-MUFA)、n-3PUFAs成負相關,差異均有統(tǒng)計學意義(P0.05)。結(jié)論:1.孕婦年齡≥30y,BMI≥24 Kg/m2,孕期增重≥12.5 kg會增加GDM的發(fā)病風險,而每周食用堅果類食物≥50 g可以有效防止GDM的發(fā)生;2.GDM孕婦較NGT孕婦膳食特點為高能量、高蛋白、高脂肪、高碳水化合物;3.孕婦在妊娠期間增加攝入不飽和脂肪酸,尤其是n-3 PUFAs,減少SFA的攝入,可能與降低胰島素抵抗指數(shù)以及空腹胰島素水平有關。
[Abstract]:Objective: the purpose of this study is to study dietary intake. Erythrocyte membrane phospholipid fatty acid spectrum and gestational diabetes mellitus (GDM). Methods We collected 73 GDM late pregnant women and 74 healthy third trimester pregnant women in the first people's Hospital of Jining. As the case group (GDM group) and control group (NGT group), collect the basic physiological and biochemical parameters of pregnant and lying-in women. Seven days dietary intake was recorded and red blood cell membrane phospholipid fatty acid spectrum was detected by gas chromatograph. The difference of maternal diet and erythrocyte membrane phospholipid fatty acid spectrum between the two groups was analyzed statistically. The factors influencing the incidence of GDM were studied by two-class unconditioned logistic regression, and the relationship between GDM and dietary intake was discussed by partial correlation analysis. Results 1. Age, uterus height, abdominal circumference, gestational age, pre-pregnancy weight, prenatal weight, weight gain during pregnancy in GDM group were higher than those in NGT group. Body mass index (BMI), fetal body weight (FW) Apgar score, uric acid (UAA), creatinine (Cr), Albumin (ALB), insulin resistance index (HOMA-IRR). The difference of fasting insulin FIns was statistically significant (P 0.05). 2.The dietary intake of protein in the NGT group was significantly higher than that in the NGT group (108.50 鹵19.21g vs.99.16 鹵16.40g). The fat intake of GDM group was significantly higher than that of NGT group (103.53 鹵21.99g vs.93.32 鹵18.67g). Carbohydrate intake in GDM group was significantly higher than that in NGT group (357.03 鹵51.80 g vs.292.39 鹵52.60 g / g). The total dietary energy of GDM group was significantly higher than that of NGT group (2648.82 kcal vs.2305.42 kcal). In GDM group, VitB1Vit B2Vit, potassium, sodium, magnesium, iron, zinc, phosphorus, threonine, grain energy, fruit energy, meat energy, vegetable energy. Egg energy was significantly higher than NGT group, while fish and shrimp energy NGT group was significantly higher than GDM group (90.19 kcal vs.37.73 kcal). The difference was statistically significant (P 0.05). 3.The fatty acid spectrum of erythrocyte membrane phospholipid in group C 16: 0: C 18: 0, total saturated fatty acid (SFA). The total n-6 polyunsaturated fatty acid (PUFAA) / n-3 PUFA was significantly higher than that in GDM group (total monounsaturated fatty acid), total monounsaturated fatty acid (MUFA/SFA) and total monounsaturated fatty acid (MUFA/SFA). C22: 6n-3 + C18: 1n-9 / C22: 5n-3C22: 6n-3 PUFAs were significantly higher than those of NGT group (P 0.05). 4. BMI 鈮，

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