益生菌补充剂对饮食控制型妊娠期糖尿病患者胰岛素抵抗的影响  

Effects of probiotic supplements on insulin resistance in patients with diet⁃controlled gestational diabetes mellitus

作　　者：张新艳 付超[1] 安琦[1] 白军[2] 贾立周 ZHANG Xin⁃yan;FU Chao;AN Qi;BAI Jun;JIA Li⁃zhou(Department of Obstetrics,Bayannur 015000,Inner Mongolia Autonounous Regions,China;Department of Rehabilitation Physiotherapy,Bayannur 015000,Inner Mongolia Autonounous Regions,China;Cancer Integrated Medical Center,Bayannur Hospital,Bayannur 015000,Inner Mongolia Autonounous Regions,China)

机构地区：[1]巴彦淖尔市医院产科,巴彦淖尔015000 [2]巴彦淖尔市医院康复理疗科,巴彦淖尔015000 [3]巴彦淖尔市医院肿瘤整合医学中心,巴彦淖尔015000

出　　处：《医学研究生学报》2020年第6期609-612,共4页Journal of Medical Postgraduates

基　　金：内蒙古自治区应用技术研究与开发资金项目(201802138)。

摘　　要：目的目前益生菌补充剂对饮食控制型妊娠期糖尿病(GDM)患者的治疗效果报道较少。文中旨在评估益生菌补充剂对饮食控制型GDM患者胰岛素抵抗的影响。方法选取巴彦淖尔市医院产科2018年2月至12月122例能通过饮食和运动控制血糖小于92 mg/dL的饮食控制型GDM孕妇。采用随机双盲法分为:益生菌组(含有双歧杆菌和乳酸杆菌的益生菌补充剂)和安慰剂组(安慰剂胶囊),均连续治疗4周,每组61例。主要评估指标为2组空腹血糖、空腹血浆胰岛素和胰岛素抵抗指数(HOMA⁃IR)的平均差异,次要评估指标为干预后孕妇体重的变化。结果益生菌组干预后空腹血糖增加量[(0.59±6.42)mg/dL]、空腹血浆胰岛素水平增加量[(1.14±1.95)mIU/mL]、HOMA⁃IR增加量(0.27±0.45)显著低于安慰剂组[(4.78±7.47 mg/dL)、(3.86±1.82)mIU/mL、(0.86±0.59)],差异有统计学意义(P<0.05)。益生菌组和安慰剂组孕妇妊娠期间体重总增重、新生儿出生体重及新生儿低血糖发生率差异无统计学意义(P>0.05)。结论在妊娠期,饮食控制型GDM患者服用4周的益生菌补充剂可降低空腹血糖,增加胰岛素敏感性,益生菌补充剂可以作为饮食控制型GDM患者血糖控制的辅助治疗。Objective At present,there are few reports on the therapeutic effect of probiotic supplements in patients with di⁃etary⁃controlled gestational diabetes mellitus(GDM).This study aims to evaluate the effect of probiotic supplements on insulin resist⁃ance in patients with dietary⁃controlled GDM.Methods 122 pregnant women with dietary⁃controlled GDM who could control blood glucose less than 92 mg/dL through diet and exercise were selected from the Obstetrics Department in Bayannur Hospital from February to December 2018.The patients were randomly divided into two groups:Probiotics Group(probiotic supplements containing bifidobac⁃terium and lactobacillus)and Placebo Group(placebo capsules).61 patients in each group were treated continuously for 4 weeks.The main evaluation index was the mean difference of fasting blood glucose,fasting plasma insulin and insulin resistance index(HOMA⁃IR)between the two groups,and the secondary evaluation index was the change of maternal weight after intervention.Results The increase of fasting blood glucose[(0.59±6.42)mg/dL],fasting plasma insulin[(1.14±1.95)mIU/mL]and HOMA⁃IR(0.27±0.45)in the Probiotics Group after intervention were significantly lower than those in the Placebo Group[(4.78±7.47 mg/dL),(3.86±1.82)mIU/mL,(0.86±0.59)],and the difference was statistically signifi⁃cant(P<0.05).There was no significant difference in total weight gain,neonatal birth weight and neonatal hypoglycemia between the two groups(P>0.05).Conclusion During pregnancy,probiotic supplements for four weeks in patients with dietary⁃controlled GDM can reduce fasting blood glucose and increase insulin sensitivity.Therefore,probiotic supplements can be used as adjunctive therapy for blood glucose control in patients with dietary⁃controlled GDM.

关 键 词：妊娠期糖尿病 饮食控制型 胰岛素抵抗 益生菌 

分 类 号：R587.1[医药卫生—内分泌]