中等强度抗阻力运动对妊娠期糖尿病孕妇孕期体重增加和心脏代谢谱的影响  

Effects of moderate-intensity resistance exercise on gestational weight gain and cardiometabolic profile in pregnant women with gestational diabetes mellitus

作　　者：刘丽娜 邓春霞 李梅[1] 孙鸿博 Liu Lina;Deng Chunxia;Li Mei(Department of Gynaecology and Obstetrics,Tsinghua University Affiliated Chuiyangliu Hospital,Beijing 100022)

机构地区：[1]清华大学附属垂杨柳医院妇产科,北京100022

出　　处：《中华保健医学杂志》2024年第5期662-666,共5页Chinese Journal of Health Care and Medicine

基　　金：北京朝阳区科委课题项目(CYSF161201)。

摘　　要：目的探讨中等强度抗阻力运动对妊娠期糖尿病(GDM)孕妇孕期体重增加(GWG)和心脏代谢谱的影响。方法选取2020年1月~2022年3月于清华大学附属垂杨柳医院内分泌科和高危产科接受产前随访的108例GDM患者作为研究对象,按照简单的随机化方法分为观察组(n=55)和对照组(n=56),其中,观察组进行中等强度抗阻力运动,对照组进行有氧运动。探讨两种运动方式对GDM孕妇GWG和心脏代谢谱的影响。结果干预后,观察组空腹血糖和餐后2 h血糖均低于对照组,差异均有统计学意义(t=3.420、3.988,P<0.05)。对照组巨大儿比例(51.85%)高于观察组(27.78%),差异有统计学意义(χ^(2)=6.530,P=0.011)。与对照组相比,观察组分娩前体重、GWG均较低,差异均有统计学意义(Z=-4.449、-5.128,P<0.05)。与对照组相比,观察组分娩前收缩压、糖化血红蛋白(HbAlc)、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)、C肽均较低,差异均有统计学意义(Z=-2.486、-2.205、-2.538、-2.755、-2.843,P<0.05)。偏相关系数分析结果显示,GWG与分娩前心脏代谢谱均呈正相关,包括收缩压、CRP、HbAlc、HOMA-IR、C肽(r=0.153,0.157,0.172,0.267,0.247,P<0.001),与血清HMW脂联素水平呈负相关(r=-0.141,P=0.047)。结论中等强度阻力运动改善了GDM患者的血糖控制、胰岛素使用、妊娠期体重增加和心血管疾病的发生风险,对GDM孕妇安全、可行。Objective To investigate the effects of moderate-intensity resistance exercise on gestational diabetes mellitus(GDM),gestational weight gain(GWG),and cardiometabolic profiles.Methods Taking 111 GDM patients who received prenatal follow-up in the Department of Endocrinology and High-risk Obstetrics of a tertiary general hospital from January 2020 to March 2022 as the study subjects,they were divided into observation group(n=55)and control group(n=56)according to the randomization method,with the observation group undergoing resistance exercise and the control group undergoing aerobic exercise.To study the effects of exercise patterns on GWG and cardiometabolic profiles.Results After the intervention,the average fasting blood glucose and 2h postprandial blood glucose levels in the observation group were lower than those in the control group,the difference was statistically significant(t=3.420,3.988,P<0.001).The proportion of macrosomia in control group(51.85%)was significantly higher than that in observation group(27.78%)(χ^(2)=6.530,P=0.011).The body weight of the observation group before delivery,GWG significantly lower than the control group(P<0.05).In the observation group,systolic blood pressure before delivery,hemoglobin a1c(HbAlc),fasting insulin,Insulin resistance index(HOMA-IR),C-peptide were significantly lower than those in the control group(Z=-2.486、-2.205、-2.538、-2.755、-2.843,P<0.05).By partial correlation coefficient analysis,GWG and pre-delivery cardiometabolic spectrum,including systolic blood pressure,CRP,HbAlc,HOMA-IR,C-peptide(r=0.153,0.157,0.172,0.267,0.247,P<0.001)were positively correlated with serum HMW adiponectin level(r=-0.141,P=0.047).Conclusion Moderate-intensity resistance exercise improves glycaemic control,insulin use,gestational weight gain,and cardiovascular risk in people with GDM,and moderateintensity resistance exercise is safe and feasible for pregnant women with GDM.

关 键 词：妊娠期糖尿病 孕期体重增加 心脏代谢风险 阻力运动 有氧运动 

分 类 号：R714[医药卫生—妇产科学]