早期饮食运动干预对妊娠糖尿病高危因素孕妇的胰岛素抵抗和妊娠预后的影响  

Effect of early dietary advice and exercise intervention on insulin resistance and pregnancy outcome in pregnant women with high-risk factors for gestational diabetes mellitus

作　　者：陈勇霞[1] 田耕[1] 苗润[1] 萧慧娟[1] 

机构地区：[1]广州医学院第二附属医院妇科,广州51026

出　　处：《新医学》2013年第4期231-234,共4页Journal of New Medicine

基　　金：广东省医学研究基金资助(A2012258)

摘　　要：目的:探讨早期饮食运动干预对有妊娠糖尿病(GDM)高危因素孕妇胰岛素抵抗及妊娠预后的影响。方法:160例GDM高危因素的孕妇随机分为饮食运动干预组(90例)和非干预组(70例),干预组在孕期12周时开始进行干预,至妊娠末期(孕37周末)结束;记录两组在不同孕期的血糖(空腹、餐后2 h)、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)和体质量变化,比较GDM发生率及妊娠结局的差异。结果:干预组空腹胰岛素、HOMA-IR于饮食运动干预后逐渐下减,GDM发病率明显降低,与非干预组比较差异有统计学意义(P<0.05)。干预组母婴并发症明显低于非干预组,两组比较差异有统计学意义(P<0.05)。结论:GDM高危因素的孕妇早期饮食运动干预能改善胰岛素抵抗,降低GDM的发生,并改善妊娠的结局和减少母婴并发症。Objective： To explore the effect of early dietary advice and exercise intervention （DAEI） on insu- lin resistance and pregnancy outcome in pregnant women with high-risk factors for gestational diabetes mellitus （GDM）. Methods： One hundred and sisty pregnant women with high-risk factors for GDM were divided randomly into DAEI group （90 cases） and observation group （70 cases）. The intervention started in 12 weeks after pregnan- cy and ended in final-phase of pregnancy （ends of 37 weeks）. FBG, glucose in 2 h OGTT, insulin, insulin re- sistance index, and body weight changes were recorded. The incidence of GDM and pregnancy outcome were com- pared. Results： Compared with observation group, insulin, insulin resistance index decreased gradually in preg- nancy with high-risk factors for GDM, and the incidence of GDM was lower in DAEI group, with significant differ- ence （P 〈 0.05）. Complications of mothers and perinatals was lower in DAEI group than those in observation group, with significant difference （P 〈 0. 05 ）. Conclusion ： Early DAEI could improve insulin resistance, reduce GDM incidence, and improve the pregnancy outcome and reduced complications of mothers and perinatals.

关 键 词：妊娠糖尿病 高危因素 饮食运动干预 胰岛素抵抗 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]