中心性肥胖不孕症患者生活方式干预效果评价  

Effect evaluation of online lifestyle intervention on women with infertility and central obesity

作　　者：吴祎丹 傅晓华[1] 朱晶[1] 吴香丽[1] WU Yidan;Fu Xiaohua;ZHU Jing;Wu Xiangli(Department of Reproductive Endocrinology,Zhejiang Provincial People's Hospital(People's Hospital of Hangzhou Medical College),Hangzhou,Zhejiang 310014,China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)生殖内分泌科,浙江杭州310014

出　　处：《预防医学》2021年第11期1097-1099,1104,共4页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：浙江省医药卫生科技计划面上项目(2020KY451);浙江省医药卫生学科平台项目(2018ZD012)。

摘　　要：目的评价中心性肥胖不孕症患者基于认知行为调整的线上生活方式干预效果。方法选择2019年11月—2020年12月在浙江省人民医院生殖中心就诊并纳入健康管理的中心性肥胖不孕症患者,分配到干预组和对照组。干预组实施基于认知行为调整的线上生活方式干预12周,对照组实施常规宣传教育。比较2组患者干预前后体重、腰围、空腹血糖、空腹胰岛素、胰岛素抵抗指数和体脂率等指标;妊娠随访至干预后6个月,比较2组妊娠率和流产率。结果干预组和对照组各纳入78例,年龄分别为(31.15±4.87)岁和(31.17±4.81)岁。干预前两组患者年龄、体重、体质指数、腰围、腰臀比、空腹血糖、空腹胰岛素、胰岛素抵抗指数和体脂率差异均无统计学意义(P>0.05)。混合效应模型结果显示,干预组患者腰围、空腹胰岛素和体脂率的下降幅度均大于对照组(P<0.05)。干预组和对照组患者辅助生殖后妊娠率分别为33.33%和23.08%,流产率分别为7.69%和16.67%,差异均无统计学意义(P>0.05)。结论基于认知行为调整的线上生活方式干预有助于中心性肥胖不孕症患者改善中心性肥胖和高胰岛素状态。ObjectiveTo evaluate the effect of online lifestyle intervention based on cognitive behavior adjustment onthe female patients with infertility and central obesity.MethodsFrom November 2019 to November 2020,the womenwith infertility and central obesity in the Reproductive Medicine Center of Zhejiang Provincial People’s Hospital wererecruited and divided into two groups.The intervention group received online lifestyle intervention based on cognitive be-havior adjustment for twelve weeks,and the control group received routine health education.Body weight,waist circum-ference,fasting blood glucose,fasting insulin,insulin resistance index(HOMA-IR),body fat,the pregnancy rate andthe abortion rate were compared between the two groups.ResultsThere were 78 cases each in the intervention groupand the control group,aged(31.15±4.87)years and(31.17±4.81)years,respectively.There were no significant differ-ences between the two groups in age,body weight,body mass index,waist circumference,waist-hip ratio,fasting bloodglucose,fasting insulin,HOMA-IR and body fat percentage before intervention(all P>0.05).After twelve-week interven-tion,the results of mixed effect model showed that the decrease of waist circumference,fasting insulin and body fat per-centage in the intervention group were greater than those in the control group(all P<0.05).After six-month follow-up,there was no significant differences in the pregnancy rate(33.33%vs.23.08%)and the abortion rate(7.69%vs.16.67%)between the two groups(both P>0.05).ConclusionOnline lifestyle intervention based on cognitive behavioradjustment helps to control central obesity and hyperinsulinemia.

关 键 词：中心性肥胖 不孕症 生活方式干预 认知行为调整 

分 类 号：R711.6[医药卫生—妇产科学]