孕妇整体饮料摄入质量及其与糖代谢的关系研究  

A study on the quality of overall beverage intake and its associations with glucose metabolism in pregnant women

作　　者：蓝敏艳 陈雅晴 刘渝 何旋庆 古晓楠 黄舒悦 李梦帆 蔡莉[1] LAN Minyan;CHEN Yaqing;LIU Yu;HE Xuanqing;GU Xiaonan;HUANG Shuyue;LI Mengfan;CAI Li(Department of Maternal and Child Health,School of Public Health,Sun Yat-sen University,Guangzhou 510080,China;Preventive Medicine,School of Public Health,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学公共卫生学院妇幼卫生学系,广州510080 [2]中山大学公共卫生学院预防医学专业,广州510080

出　　处：《中华疾病控制杂志》2025年第1期27-33,共7页Chinese Journal of Disease Control & Prevention

基　　金：广东省自然科学基金(2023A1515030192,2024A1515011522)。

摘　　要：目的采用健康饮料指数(healthy beverage index,HBI)评价孕妇整体饮料摄入质量,并探讨其与糖代谢水平及妊娠期糖尿病(gestational diabetes mellitus,GDM)的关联。方法纳入2017―2018年孕20~28周的孕妇1029人,采用食物频率问卷面对面收集各类饮料摄入量及频率,计算HBI的10种亚类得分和总分,总分为100分。通过口服葡萄糖耐量试验和血样检测评估孕妇糖代谢水平并诊断GDM。采用多重线性回归及logistic回归分析模型进行关联性分析。结果孕妇HBI平均总分为(79.81±9.84)分,18.85%的孕妇患GDM。亚类中,相对于含糖饮料摄入较多的孕妇,含糖饮料摄入较少的孕妇空腹血糖水平较低(B=-0.39,95%CI:-0.63~-0.51,P=0.002);相较于总液体摄入能量较多的孕妇,总液体摄入能量较少的孕妇空腹血糖水平(B=-0.09,95%CI:-0.17~-0.01,P=0.020)及GDM风险较低(OR=0.52,95%CI:0.29~0.90,P=0.024)。未发现HBI总分及其他亚类与糖代谢水平、GDM的关联。结论首次采用HBI评估孕妇整体饮料摄入,发现其得分较高。符合指南推荐的含糖饮料摄入及总液体摄入能量与空腹血糖水平及GDM风险降低有关。Objective To evaluate the overall quality of beverage intake among pregnant women using the healthy beverage index(HBI)and explore its association with glucose metabolism levels and gestational diabetes mellitus(GDM).Methods From 2017 to 20181029 pregnant women at 20-28 weeks of gestation were enrolled.Beverage intake quantity and frequency were collected using the food frequency questionnaire through face-to-face interviews.Scores for the 10 subcategories and total score of HBI,with a maximum total score of 100,were calculated.Oral glucose tolerance tests and blood sample analyses were conducted to evaluate glucose metabolism levels and diagnose GDM.Multiple linear regression and logistic regression were conducted for association analysis.Results The average HBI score was(79.81±9.84),with 18.85%diagnosed with GDM.Among the subcategories,compared to pregnant women with higher sugar-sweetened beverage intake,those with lower sugar-sweetened beverage intake had lower fasting blood glucose(B=-0.39,95%CI:-0.63--0.51,P=0.002).Compared to pregnant women with higher total beverage energy,those with lower total beverage energy had lower fasting blood glucose(B=-0.09,95%CI:-0.17--0.01,P=0.020)and a reduced risk of GDM(OR=0.52,95%CI:0.29-0.90,P=0.024).No significant associations of HBI total score and scores of other HBI subcategories with glucose metabolism levels or GDM were found.Conclusions This is the first study utilizing HBI to evaluate the overall quality of beverage intake among pregnant women,and the results show that pregnant women scored relatively high.Sugar-sweetened beverages and total beverage energy in line with guidline recommendation were associated with lower fasting blood glucose and reduced GDM risk.

关 键 词：孕妇 健康饮料指数 糖代谢 妊娠期糖尿病 

分 类 号：R173[医药卫生—妇幼卫生保健]