低升糖指数饮食模式对妊娠期糖尿病妊娠结局影响的Meta分析  

Effect of Low Glycemic Index Diet on Pregnancy Outcome of Gestational Diabetes Mellitus:A Meta-analysis

作　　者：盛金叶 吴瑞臻 梁肖肖 汤庆娅[1] 冯一[1] SHENG Jin-ye;WU Rui-zhen;LIANG Xiao-xiao;TANG Qing-ya;FENG Yi(Department of Clinical Nutrition,Xinhua Hospital Affiliated to Medical of Shanghai Jiaotong University,Shanghai 200092,China;Department of clinical nutrition,EYE and ENT Fudan University,Shanghai 200092,China;Chongming branch of Xinhua Hospital Affiliated to Medical of Shanghai Jiaotong University,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院临床营养科,上海200092 [2]复旦大学附属眼耳鼻喉科医院临床营养科,上海200031 [3]上海交通大学医学院附属新华医院崇明分院临床营养科,上海202150

出　　处：《中国食物与营养》2023年第12期56-61,共6页Food and Nutrition in China

基　　金：上海卫生健康系统重要薄弱学科建设-临床营养学(项目编号:2019ZB0101)。

摘　　要：目的:系统评价低升糖指数饮食模式对妊娠期糖尿病妊娠结局的影响,为妊娠期糖尿病患者提供合理的饮食模式。方法:通过检索PubMed、Cochrane library、Embase及中国知网,采用随机对照试验(RCT)评估低升糖指数(GI)饮食对妊娠期糖尿病妊娠结局的影响。2位研究者独立地搜索文章,提取数据,并评估纳入研究的质量。1位研究者采用随机效应模型进行Meta分析。结果:10篇共计689例的RCT纳入Meta分析。较常规糖尿病饮食干预模式,低升糖指数的饮食干预模式可以显著降低妊娠期糖尿病患者空腹血糖水平[WMD=-0.58,95%CI(-0.98,-0.18),P=0.005],餐后2 h血糖水平[WMD=-1.01,95%CI(-1.54,-0.48),P<0.0002],胰岛素抵抗水平[WMD=-0.14,95%CI(-0.17,-0.10),P<0.0001]。就妊娠结局而言,可以降低孕期体重增加[RR=0.44,95%CI(0.27,0.73),P=0.002],巨大儿的发生率[RR=0.48,95%CI(0.25,0.91),P=0.02]。结论:对患有妊娠期糖尿病的孕妇在孕期使用低升糖指数的饮食模式可有助于改善其血糖、胰岛素抵抗水平以及围产期结局。【Objective】To systematically evaluate the effect of low glycemic index diet on pregnancy outcome of gestational diabetes mellitus(GDM),and to provide a reasonable diet for patients with GDM.【Method】PubMed,Cochrane Library,EMBASE and CNKI were searched to evaluate the effect of low glycemic index(GI)diet on pregnancy outcome of gestational diabetes mellitus(GDM)by randomized controlled trials(RCTs).Two researchers independently searched for articles,extracted data,and assessed the quality of included stud⁃ies.One researcher used random effects model for meta-analysis.【Result】Ten RCTs involving 689 cases were included in the metaanalysis.Compared with the conventional diet intervention model,the diet intervention model with low glycemic index could significantly reduce the fasting blood glucose level[WMD=-0.58,95%CI(-0.98,-0.18),P=0.005],2-hour postprandial blood glucose level[WMD=-1.01,95%CI(-1.54,-0.48),P<0.0002],insulin resistance level[WMD=-0.14,95%CI(-0.17,-0.10),P<0.0001].In terms of pregnancy outcome,it can reduce the weight gain during pregnancy[RR=0.44,95%CI(0.27,0.73),P=0.002]and the incidence of macrosomia[RR=0.48,95%CI(0.25,0.91),P=0.02].【Conclusion】The low glycemic index diet can improve the blood glucose,insulin resistance and perinatal outcomes of pregnant women with gestational diabetes mellitus.

关 键 词：妊娠期糖尿病 低升糖指数 饮食干预 META分析 血糖 围产结局 

分 类 号：R714.256[医药卫生—妇产科学]