个体化医学营养疗法联合胰岛素对妊娠糖尿病患者的血糖控制水平及miR-101表达水平的影响  

Effects of individualized medicine nutrition therapy combined with insulin on blood glucose control level and miR-101 expression level in gestational diabetes mellitus

作　　者：苏妍[1] 关娜[2] 郑万辉 张亚平 SU Yan;GUAN Na;ZHENG Wanhui;ZHANG Yaping(Department of Internal Medicine,Tangshan Maternal and Child Health Hospital,Tangshan,Hebei 063000,China;General Department of Chengde Central Hospital,Chengde,Hebei 067000,China;Department of Endocrinology,Luannan County Hospital,Tangshan,Hebei 063599,China;Department of Internal Medicine,Chengde Shuangluan District People’s Hospital,Chengde,Hebei 067101,China)

机构地区：[1]唐山市妇幼保健院内科,河北唐山063000 [2]承德市中心医院全科,河北承德067000 [3]滦南县医院内分泌科,河北唐山063599 [4]承德市双滦区人民医院内科,河北承德067101

出　　处：《中国优生与遗传杂志》2024年第12期2663-2669,共7页Chinese Journal of Birth Health & Heredity

基　　金：河北省2023年度医学科技研究课题计划(20231757)。

摘　　要：目的分析个体化医学营养疗法联合胰岛素对妊娠糖尿病(GDM)患者的血糖控制水平及微小RNA(miRNA)-101表达水平的影响。方法选取2020年4月至2022年4月唐山市妇幼保健院妇产科接诊的110例GDM患者展开回顾性研究,根据治疗方法的不同将其分为对照组和观察组两组,各55例。对照组给予胰岛素治疗,观察组在对照组基础上给予个体化医学营养治疗,比较两组孕期体质量增长情况、血糖指标、控制血糖达标时间、低血糖发生率、血清miR-101表达量、妊娠并发症总发生率。比较有、无妊娠并发症组血清miR-101表达量,绘制受试者操作特征(ROC)曲线,计算ROC曲线下面积(AUC),分析血清miR-101对妊娠并发症的预测效能。结果观察组孕中期、孕晚期、孕全期体质量增长量、孕全期体质量增长值与推荐值的差值、空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、血清miR-101表达量均低于对照组(P<0.05)。观察组控制血糖达标时间短于对照组(P<0.05),观察组低血糖发生率(1.82%)、妊娠并发症总发生率均低于对照组(P<0.05)。有妊娠并发症组血清miR-101表达量高于无妊娠并发症组(P<0.05)。血清miR-101预测妊娠并发症的灵敏度是95.28%、特异度是91.74%。结论个体化医学营养疗法联合胰岛素可有效调控GDM患者体质量增长,降低血糖值及低血糖发生率,缩短血糖达标时间,抑制血清miR-101高表达,改善妊娠结局,临床可通过检测血清miR-101水平,提高对妊娠并发症发生风险的预测效能,从而指导临床及早展开针对性治疗,最大限度保障母婴安全。Objective To analyze the effects of individualized medicine nutrition therapy combined with insulin on blood glucose control level and mirNA-101 expression level in patients with gestational diabetes mellitus(GDM).Methods A retrospective study was conducted on 110 patients with gestational diabetes mellitus(GDM)admitted to the Obstetrics and Gynecology Department of Tangshan Maternal and Child Health Hospital from April 2020 to April 2022.According to different treatment methods,they were divided into two groups,with 55 patients in each group.The control group received insulin treatment,while the observation group received personalized medical nutrition treatment on the basis of the control group.The growth of body mass during pregnancy,blood glucose indicators,time to control blood glucose,incidence of hypoglycemia,serum miR-101 expression level,and total incidence of pregnancy complications were compared between the two groups.Compare the expression levels of serum miR-101 between groups with and without pregnancy complications,plot the receiver operating characteristic(ROC)curve,calculate the area under the curve(AUC),and analyze the predictive power of serum miR-101 for pregnancy complications.Results The observation group showed lower body mass growth during mid pregnancy,late pregnancy,and throughout pregnancy,as well as the difference between the recommended and whole pregnancy weight growth values,fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),and serum miR-101 expression levels compared to the control group(P<0.05).The observation group had a shorter time to control blood glucose levels compared to the control group(P<0.05),and the incidence of hypoglycemia(1.82%)and total incidence of pregnancy complications were lower in the observation group than in the control group(P<0.05).The serum miR-101 expression level in the group with pregnancy complications was higher than that in the group without pregnancy complications(P<0.05).The sensitivity and specificity

关 键 词：个体化医学营养疗法 胰岛素 妊娠糖尿病 微小RNA-101 

分 类 号：R71[医药卫生—妇产科学]