益生菌结合维生素D对妊娠期糖尿病糖脂代谢、胰岛素抵抗的影响  

Effects of Probiotics Combined with Vitamin D on Glucose-lipid Metabolism and Insulin Resistance in Patients with Gestational Diabetes Mellitus

作　　者：杨艳 叶佳 杨敏 官世红 YANG Yan;YE Jia;YANG Min;GUAN Shi-hong(Obstetrics Department,Maternity and Child Care Hospital in Jiangjin District,Chongqing 402260,China)

机构地区：[1]重庆市江津区妇幼保健院产科,重庆402260

出　　处：《解放军医药杂志》2020年第11期71-74,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：重庆市卫生和计划生育委员会重点项目(2015ZDXM082)。

摘　　要：目的观察益生菌联合维生素D对妊娠期糖尿病(GDM)孕妇糖脂代谢、胰岛素抵抗及临床结局的影响。方法选择2018年2月-2019年6月在我院分娩的90例GDM孕妇为研究对象,按治疗方法分为观察组与对照组,每组45例;对照组在常规治疗基础上联合维生素D,观察组在对照组基础上联合益生菌,观察2组的临床疗效。结果2组空腹血糖、餐后2 h血糖、空腹胰岛素、胰岛素抵抗指数及甘油三酯、总胆固醇、低密度脂蛋白水平较治疗前显著降低,且观察组低于对照组(P<0.05);2组胰岛β细胞分泌指数、高密度脂蛋白胆固醇较治疗前显著增加,且观察组高于对照组(P<0.05)。2组白介素-6、肿瘤坏死因子-α较治疗前显著降低,且观察组低于对照组(P<0.05);2组母婴不良结局发生率比较差异无统计学意义(P>0.05)。结论维生素D联合益生菌较单独维生素D治疗更能有效降低GDM孕妇的血糖、血脂、空腹胰岛素水平,有效增强胰岛β细胞功能,降低胰岛素抵抗作用,但对母婴不良结局发生率无明显改善作用,其调节糖脂代谢、降低胰岛素抵抗的机制可能与抑制炎性因子表达有关。Objective To observe the effects of probiotics combined with vitamin D on glucose-lipid metabolism,insulin resistance(IR)and clinical outcomes of pregnant women with gestational diabetes mellitus(GDM).Methods A total of 90 pregnant women with GDM who gave birth in our hospital from February 2018 to June 2019 were enrolled as the research subjects.They were randomly divided into observation group and control group,with 45 cases in each group.The control group was given oral vitamin D on the basis of conventional treatment,while observation group was given probiotics combined with vitamin D.The clinical effect of the two treatment methods was observed.Results After treatment,levels of fasting blood glucose,2 h postprandial blood glucose,fasting insulin,homeostasis model assessment of insulin resistance,triglyceride,total cholesterol and low density lipoprotein cholesterol in both groups were significantly decreased,whose decrease was more significant in observation group than control group(P<0.05).After treatment,homeostasis model assessment-βand high density lipoprotein cholesterol in both groups were significantly increased,whose increase was more significant in observation group than control group(P<0.05).After treatment,interleukin-6 and tumor necrosis factor-α(TNF-α)in both groups were significantly decreased,whose decrease was more significant in observation group than control group(P<0.05).There was no significant difference in incidence of adverse maternal and infant outcomes between observation group and control group(P>0.05).Conclusion Compared with vitamin D treatment alone,vitamin D combined with probiotics can reduce levels of blood glucose,blood lipid and fasting insulin in GDM pregnant women more effectively,effectively enhance isletβcells function and reduce IR,without significant improvement effect on incidence of adverse maternal and infant outcomes.The mechanism of regulating glucose-lipid metabolism and reducing IR may be related to inhibiting the expression of inflammatory factors.

关 键 词：妊娠糖尿病 益生菌 维生素D 血糖 胰岛素抵抗 白介素-6 肿瘤坏死因子-α 

分 类 号：R714.256[医药卫生—妇产科学]