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  本文關(guān)鍵詞： 妊娠期糖尿病 同型半胱氨酸 脂聯(lián)素 抵抗素 胰島素抵抗　出處：《福建醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：了解福州市孕婦的基本情況、個人生活習慣、膳食結(jié)構(gòu)與妊娠期糖尿病發(fā)生的關(guān)系，以及妊娠期糖尿病對妊娠結(jié)局的影響。了解血清同型半胱氨酸、胰島素、脂聯(lián)素和抵抗素與妊娠期糖尿病的關(guān)系以及影響血清同型半胱氨酸水平的因素，并探討其導致胰島素抵抗的機制。 方法：在福建醫(yī)科大學附屬第一醫(yī)院行常規(guī)產(chǎn)前檢查并入院待產(chǎn)的49名妊娠期糖尿病孕婦和77名健康孕婦，采用統(tǒng)一問卷對孕婦進行調(diào)查，，內(nèi)容包括：社會人口因素、生活習慣史、飲食習慣、營養(yǎng)保健品使用情況。采用食物頻率法記錄膳食攝入情況。所有接受調(diào)查的對象空腹采靜脈血分離血清，用酶聯(lián)免疫法測定同型半胱氨酸、脂聯(lián)素、抵抗素和胰島素濃度，從入院生化檢測結(jié)果獲得血紅蛋白、總蛋白、白蛋白、球蛋白水平數(shù)據(jù)。 結(jié)果： 1．孕后的交通方式（P=0.013）在GDM孕婦和正常孕婦間有所不同，而其他基本情況以及生活習慣在兩組間未發(fā)現(xiàn)明顯差別。 2．GDM孕婦的乳類（P=0.032）和水產(chǎn)類（P=0.007）食品平均每日攝入量高于正常孕婦。以菌藻類、肉類、水產(chǎn)類和蛋類食品為主的膳食模式（P=0.027）和以水果類為主的膳食模式（P=0.002）可能與GDM發(fā)生有關(guān)。 3．GDM的發(fā)生與產(chǎn)次有關(guān)（P=0.023），還會增加產(chǎn)時出血量（P=0.001），并影響新生兒Apgar評分（P=0.013）。 4．GDM孕婦和健康孕婦的血清同型半胱氨酸水平無明顯差別，但GDM孕婦的血清脂聯(lián)素濃度較低（P=0.011），球蛋白濃度較高（P=0.028）。 5．同型半胱氨酸與抵抗素的水平呈正相關(guān)（P＜0.001），抵抗素水平（P=0.002）、產(chǎn)前BMI（P=0.029）與HOMA-IR呈正相關(guān)。 結(jié)論： 1．孕期應保持足夠的身體活動，在膳食習慣方面，應該適當增加新鮮蔬菜的攝入量，并控制動物類食品攝入量，尤其是經(jīng)產(chǎn)婦或確診GDM的孕婦。 2．將同型半胱氨酸、抵抗素、BMI共同作為GDM的危險因素進行監(jiān)測。
[Abstract]:Objective: to understand the basic situation of pregnant women in Fuzhou, the relationship between dietary structure and gestational diabetes mellitus, and the influence of gestational diabetes mellitus on pregnancy outcome, and to understand the serum homocysteine and insulin. The relationship between adiponectin and resistin and gestational diabetes mellitus and the factors influencing serum homocysteine level and the mechanism of insulin resistance were discussed. Methods: 49 pregnant women with gestational diabetes mellitus and 77 healthy pregnant women who received routine prenatal examination and were admitted to hospital at the first affiliated Hospital of Fujian Medical University were investigated with a unified questionnaire, which included: social and demographic factors. History of living habits, dietary habits, nutritional and health products use. Dietary intake was recorded by the method of food frequency. Serum samples were collected from all subjects on an empty stomach, and homocysteine and adiponectin were determined by enzyme-linked immunosorbent assay (Elisa). Resistin and insulin concentrations, obtained from the admission biochemical test results of hemoglobin, total protein, albumin, globulin level data. Results:. 1. The mode of transportation after pregnancy was different between GDM pregnant women and normal pregnant women, but there was no significant difference in other basic conditions and living habits between the two groups. 2. The average daily intake of milk (P0. 032) and aquatic (P0. 007)) of pregnant women with GDM was higher than that of normal pregnant women. The dietary patterns of bacteria, algae, meat, aquatic products and egg foods were mainly P0. 027) and the dietary pattern of P0. 002) might be related to the occurrence of GDM. 3. The occurrence of GDM was related to the number of births, and it also increased the amount of blood loss during labor and affected the Apgar score of neonates. 4. There was no significant difference in serum homocysteine levels between GDM pregnant women and healthy pregnant women, but the serum adiponectin concentration was lower and globulin concentration was higher in GDM pregnant women. 5. Homocysteine was positively correlated with resistin (P < 0.001), resistin level (P < 0.002) and pre-natal BMIP (0.029) was positively correlated with HOMA-IR. Conclusion:. 1. Adequate physical activity should be maintained during pregnancy. In dietary habits, the intake of fresh vegetables should be increased appropriately, and the intake of animal foods should be controlled, especially for pregnant women who have been diagnosed with GDM. 2. Homocysteine and resistin were used as risk factors of GDM.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.256

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