生活方式干预对肥胖妊娠糖尿病患者外周血炎性指标的影响  

Effect of Lifestyle Intervention on Inflammatory Indicators of Obese Patients with Gestational Diabetes Mellitus

作　　者：孙海玲[1] 钱雷[1] 李明[1] 吴凤会[2] 

机构地区：[1]江苏省滨海县人民医院检验科,江苏盐城224500 [2]江苏省滨海县人民医院妇产科,江苏盐城224500

出　　处：《临床医学工程》2017年第9期1213-1215,共3页Clinical Medicine & Engineering

基　　金：江苏省盐城市医学科技发展计划项目(项目编号:YC2015065)

摘　　要：目的探讨生活方式干预对肥胖妊娠糖尿病(GDM)患者外周血炎性指标的影响。方法选取我院收治的56例肥胖GDM患者(身体质量指数>30 kg/m2),随机平均分为干预组和对照组。对照组接受孕期健康教育和常规产检,干预组在此基础上进行个体化饮食指导和运动干预。采用食物频率调查表记录两组患者的孕期饮食,并检测外周血APN、血脂、HOMA-IR、CRP、IL-6和TNF-α水平。结果干预后,干预组的蛋白质、脂肪和总热量摄入均低于对照组,差异有统计学意义(P<0.05)。干预组的空腹血糖、HOMA-IR均低于对照组,HDL-C和APN均高于对照组,差异均有统计学意义(P<0.05)。干预组的IL-6和CRP水平均低于对照组,差异有统计学意义(P<0.05),但两组的TNF-α水平比较差异无统计学意义(P>0.05)。干预组的胰岛素使用率、新生儿出生体重和孕期体重增加均明显低于对照组,差异有统计学意义(P<0.05)。结论对肥胖GDM患者进行生活方式干预后,糖代谢得到较好的控制,其机制可能是生活方式干预降低了外周血炎性指标水平。Objective To study the effect of lifestyle intervention on peripheral blood inflammatory indicators in obese patients with gestational diabetes mellitus （GDM）. Methods 56 cases of obese patients （body mass index 〉 30 kg/m2） with GDM were selected and randomly divided into intervention group and control group equally. The control group received pregnancy health education and routine health check, while the intervention group received individual diet guidance and exercise intervention on this basis. The food frequency questionnaire was used to investigate the prenatal diet of two groups. The APN of peripheral blood, blood lipid, HOMA-IR, CRP, 1L-6 and TNF-α levels were measured. Results After intervention, the intake of protein, fat and total calorie of intervention group was lower than that of control group, with statistical difference （P〈0.05）. The fasting blood glucose and HOMA-IR of intervention group were lower than those of control group, and HDL-C and APN were higher than those of control group, with statistical differences （P 〈0.05）. The IL-6 and CRP levels of intervention group were lower than those of control group （P 〈0.05）, but no statistical difference was found in TNF-α level between two groups （P〉0.05）. The insulin use rate, neonatal birth weight and weight gain during pregnancy of intervention group were significantly lower than those of control group （P〈0.05）. Conclusions After lifestyle intervention, the glucose metabolism of obese patients with GDM is better controled, which mechanism is probably through lifestyle interventions to reduce peripheral blood inflammatory indicators.

关 键 词：妊娠糖尿病 生活方式干预 肥胖 C反应蛋白 白细胞介素-6 

分 类 号：R715.3[医药卫生—妇产科学]