孕中期膳食结构对妊娠期糖代谢水平的影响  

Effects of dietary pattern in mid trimester on glycometabolism level in pregnancy

作　　者：崔丽君[1] 赵淑荣[1] 李丽[1] 张素娥[1] 李彤娟[1] 张素芬[1] 

机构地区：[1]河北省石家庄市妇产医院,050081

出　　处：《中国妇幼保健》2009年第21期2920-2923,共4页Maternal and Child Health Care of China

摘　　要：目的:探讨膳食结构、尤其是脂肪类食物在妊娠期糖代谢异常发病过程中的作用。方法:选择孕24～28周检查诊断为妊娠期糖尿病(GDM)和妊娠期糖耐量减低(GIGT)孕妇62例作为GDM组,选择同期糖试验正常(GNGT)孕妇65例作为对照组。对GDM组孕妇饮食干预治疗前进行膳食和活动状况的调查。比较两组孕妇体重指数、活动水平、代谢率和膳食结构中三大营养素供能比例,特别是膳食脂肪、脂肪酸类型等。结果:①GDM组孕妇每日需要量为(2419±41)kcal,摄入能量为(2188±53)kcal;对照组每日需要量和摄入量分别为(2421±39)kcal和(2141±32)kcal,两组比较差异无统计学意义(P>0.05)。GDM组孕妇体重指数(BMI)和活动水平(PAL)为(28.2±0.8)kg/m2和1.35±0.02,对照组为(25.1±0.4)kg/m2和1.42±0.01,GDM组体重指数高于对照组,活动水平低于对照组,两组比较均具明显统计学差异(P<0.01)。②GDM组孕妇碳水化合物、蛋白质和脂肪供能百分比分别为(53.1±3.7)%、(17.0±0.4)%和(29.3±1.3)%,对照组分别为(53.1±1.7)%、(16.9±0.6)%和(26.0±1.0)%。GDM组脂肪供能百分比高于对照组,两组比较差异具有统计学意义(P<0.05);两组碳水化合物和蛋白质供能百分比比较,差异无统计学意义(P>0.05)。③问卷调查显示,两组孕妇膳食种类摄入相对量"适量"占80.5%～91.9%。孕妇饱和脂肪酸(SFA)主要来源于猪、牛、羊、鸡等动物,绝对值比较GDM组摄入频率高于对照组;多不饱和脂肪酸(PUFA)主要来源于鱼、植物油、坚果类,GDM组低于对照组;单不饱和脂肪酸(MUFA)主要来源于植物油、鸡蛋和菌类,两组略有差异。结论:①孕妇高脂肪、高SFA和低PUFA的饮食结构可能与妊娠期糖代谢异常的发病有关。②孕期应控制孕妇BMI的增加,根据BMI指导营养摄入及活动水平。Objective： To explore the effects of dietary pattern in mid trimester, especially high -fat food on glycometabolism level in pregnancy. Methods： 62 pregnant women with 24 - 28 pregnant weeks diagnosed as gestational diabetes mellitus （GDM） and gestational impaired glucose tolerance （GIGT） were GDM group, 65 pregnant women with the same pregnant weeks and normal glucose tolerance （GNGT） were control group. For GDM group, an assessment on diet and activity was made before dietary intervention. Body mass index （BMI）, activity, metabolic rate and energy supply percentage of carbohydrate, protein and fat were compared, especially dietary fat and subtypes of fatty acids. Results： 0）The requisite amount per day in GDM group and control group were （2419 ±41 ） kilocalorie and （2 421 ±39） kilocalorie, respectively; the intake amount per day in GDM group and control group were （2 188 ±53） kilocalorie and （2 141 ±32） kilocalorie, there was no significant difference between two groups （ P 〉 0. 05 ） . The BMI and activity level were （28.2 ± 0. 8 ） kg/m2, （ 1.35 ± 0.02 ） % in GDM group and （25.1 ± 0. 4） kg/m2, （ 1.42 ± 0. 01 ） % in control group, there was significant difference between two groups （P 〈0.01） . （2）The percentages of energy supply of carbohydrate, protein and fat were （53.1 ±3.7）%, （ 17.0 ±0. 4）% and （ 29. 3 ± 1.3 ） % in GDM group and （ 53.1 ± 1.7 ） %, （ 16. 9 ±0. 6 ） % and （ 26. 0 ± 1.0 ） % in control group. The proportion of fat supply in GDM group was higher than that in control group （ P 〈 0. 05 ）, but there was no significant difference in the proportions of carbohydrate and protein supply between two groups （P 〈 0. 05 ） . （~）Aeeording to the questionnaire, pregnant women whose intakes were comparatively accounted for 80. 5% -91.9% in two groups. Pregnant women＇s intakes of saturated fatty acid （SFA） mainly derived from pork, beef, mutton and chicken and the intakes of polyunsat

关 键 词：妊娠期糖尿病 膳食类型 体重指数 

分 类 号：R715.3[医药卫生—妇产科学]