妊娠期糖尿病孕妇膳食模式与其糖脂代谢的关系  

Relationship Between Dietary Pattern and Glycolipid Metabolism in Pregnant Women with Gestational Diabetes Mellitus

作　　者：赵芸芸 李莉 马依拉·买买提[3] 朱启英[4] 尼鲁帕尔·阿不都热合曼[1] ZHAO Yun-yun;LI Li;Mayila-MAIMAITI;ZHU Qi-ying;Nilupaer-ABUDUREHEMAN(School of Public Health,Xinjiang Medical University,Wulumuqi 830000,China;State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia,Xinjiang Medical University,Wulumuqi 830000,China;Department of Clinical Nutrition,the First Affiliated Hospital of Xinjiang Medical University,Wulumuqi 830000,China;Department of Obstetrics,the First Affiliated Hospital of Xinjiang Medical University,Wulumuqi 830000,China)

机构地区：[1]新疆医科大学公共卫生学院,乌鲁木齐830000 [2]省部共建中亚高发病成因与防治国家重点实验室,乌鲁木齐830000 [3]新疆医科大学第一附属医院临床营养科,乌鲁木齐830000 [4]新疆医科大学第一附属医院产科,乌鲁木齐830000

出　　处：《中国食物与营养》2023年第12期78-84,共7页Food and Nutrition in China

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题资助项目(项目编号:SKL-HIDCA-2021-DX7)。

摘　　要：目的:探讨乌鲁木齐市妊娠期糖尿病孕妇膳食模式与孕妇糖脂代谢的关系,为孕妇孕产阶段异常血糖、血脂的调节提供理论基础。方法:选取2022年7月—2023年3月在新疆医科大学第一附属医院进行常规产检,且在孕24~28w时进行口服葡萄糖耐量试验(OGTT),确诊为妊娠期糖尿病(GDM)的170例孕妇作为研究对象,并在调查对象确诊为GDM时进行面对面的食物频率问卷调查(FFQ),以及血液样本的采集,应用主成分分析法(PCA)提取其膳食模式,采用t检验、卡方检验和Poisson回归分析的方法,分析GDM孕妇膳食模式与糖脂代谢的关系。结果:该研究纳入GDM孕妇170例,参考《威廉姆斯产科学(第24版)》血脂参考标准,将其分为GDM合并脂代谢异常组(病例组)和GDM脂代谢正常组(对照组)两组,病例组年龄Μ(QR)为33.00(4.24)岁,对照组孕周Μ(QR)为27.09(1.84)w,纳入对象的年龄、孕产阶段、文化程度、有无不良孕产史、孕前BMI、民族、孕产次在两组之间差异无统计学意义。根据因子载荷较高食物种类将提取出的膳食模式分别命名为小麦-蔬菜-豆类及粗粮-水产品、优质蛋白-加工肉、畜肉-内脏-甜品、薯类-水果和大米-油炸食品-禽肉模式。该研究中,诊断为GDM合并脂代谢异常(病例组)的孕妇有59例,患病率为34.71%,病例组患病率由高到低的膳食模式分别为大米-油炸食品-禽肉、薯类-水果、优质蛋白-加工肉、粗粮-水产品、畜肉-内脏-甜品、小麦-蔬菜-豆类模式。将膳食模式以及基本资料通过Poisson回归分析显示,以小麦-蔬菜-豆类作为参考,大米-油炸食品-禽肉膳食(RR=4.257,95%CI:1.141~15.891)与病例组的发病风险存在统计学关联,发病率提高3.257倍;以近1个月不运动为参考,近1个月运动的GDM孕妇与病例组的发病风险存在统计学关联(RR=2.261,95%CI:1.369~3.733),近1个月不运动的孕妇是近1个月运动孕妇发病率的1.261倍。结论:相比【Objective】To explore the relationship between dietary pattern and glucose and lipid metabolism in pregnant women with gestational diabetes mellitus,and to provide a theoretical basis for the regulation of abnormal blood sugar and lipid in pregnant women dur⁃ing pregnancy.【Method】Routine prenatal check-up was performed in the First Affiliated Hospital of Xinjiang Medical University from July 2022 to March 2023,and oral glucose tolerance test(OGTT)was performed at 24—28 weeks of pregnancy.A total of 170 pregnant women diagnosed with gestational diabetes mellitus(GDM)were selected as the study subjects.Face-to-face food frequency questionnaire(FFQ)and blood samples were collected when the subjects were diagnosed with GDM.PCA was used to extract their dietary patterns,and T-test,Chi-square test and Poisson regression analysis were used.To analyze the relationship between dietary pattern and glycolipid metabolism in pregnant women with GDM.【Result】Totally 170 pregnant women with GDM were included and divided into two groups including GDM combined with abnormal lipid metabolism group(case group)and GDM normal lipid metabolism group(control group).The age of case group M(QR)was 33.00(4.24)years,and the gestational age of control group M(QR)was 27.09(1.84)weeks.There were no statisti⁃cally significant differences between the two groups in age,gestational stage,educational level,history of adverse pregnancy,prepregnancy BMI,ethnicity and pregnancy times.According to the food types with high factor load,the extracted dietary patterns were named as staple wheat-vegetables-beans pattern,coarse grain-aquatic product pattern,high quality protein-processed meat pattern,animal meat-offal-dessert pattern,potato-fruit pattern and rice-fried food-poultry pattern.In this study,there were 59 pregnant women diagnosed with GDM combined with abnormal lipid metabolism(case group),with a prevalence rate of 34.71%.The dietary patterns from high to low in case group were rice-fried food-poultry meat pattern,potato-fruit p

关 键 词：主成分分析 膳食模式 妊娠期糖尿病 脂代谢异常 Poisson回归分析 

分 类 号：R714.256[医药卫生—妇产科学]