营养干预对妊娠期血糖异常孕妇糖脂代谢的影响

目的：研究营养干预对妊娠期血糖异常孕妇血糖和血脂代谢的影响.方法：采用随机对照试验设计,选取广东省人民医院产科门诊确诊为妊娠期糖代谢异常的孕妇共83例,随机分为对照组（43例）和强化营养干预组（40例）.分别检测两组孕妇孕中期和孕末期的空腹血糖、餐后2h血糖、血清总胆固醇、总甘油三酯、高密度脂蛋白、低密度脂蛋白和糖化血红蛋白,比较组间差异和前后差异.结果：强化营养干预组孕妇孕末期空腹血糖和餐后2h血糖均显著的低于对照组孕妇（P＜0.05）,但糖化血红蛋白和各血脂水平与对照组差异无显著性（P＞0.05）.强化干预组孕末期的空腹血糖和餐后2h血糖均显著低于孕中期（P＜0.05）,对照组孕末期的空腹血糖显著高于孕中期（P＜0.05）,餐后2h血糖孕末期显著低于孕中期（P＜0.05）.两组孕妇血清甘油三酯孕末期显著高于孕中期水平（P＜0.05）,总胆回醇、高密度脂蛋白、低密度脂蛋白及糖化血红蛋白水平孕末期和孕中期差异无统计学意义（P＞0.05）.结论：妊娠期糖代谢异常孕妇存在着以甘油三酯升高为主的脂代谢紊乱,强化营养干预对控制妊娠期糖代谢异常的妇女的血糖水平有显著作用,但未能发现对血脂的改善作用,其原因有待研究.

Effect of Diet Treatment on Glucose and Lipid Levels in Gestation Diabetic Pregnant Women

Objective] To investigate the effect of diet treatment on glucose and lipid levels in gestational diabetic pregnant women during pregnancy.Method] Totally 83 gestational diabetic women （GDM） from July to December in 2009 were randomly divided into control group （n =43） and diet treatment group （n =40）.Fasting serum glucose,2-hr post prandial serum glucose,serum total cholesterol （TC）,triglycerides （TG）,HDL-C,LDL-C and HbA1c were measured in the middle and late of gestation.Result] In late pregnancy,the levels of fasting serum glucose and 2-hr post prandial serum glucose of the diet treatment group were lower than the control group （P ＜0.05）.There were no statistically significant differences between the two groups in HbAlc,TC,TG,HDL-C and LDL-C （P ＞0.05）.In the treatment group,the levels of fasting serum glucose and 2-hr post prandial serum glucose in late of pregnancy were lower than those in middle of pregnancy （P ＜ 0.05）.In the control group,the level of fasting serum glucose in late of pregnancy was higher than that in middle of pregnancy,while the 2-hr post prandial serum glucose was lower than that in middle of pregnancy （P ＜ 0.05）.The triglycerides level in late pregnancy was higher than that in the middle of pregnancy of the two groups （P ＜0.05）.There were no statistically significant differences in HbAlc,TC,HDL-c and LDL-c between middle and late pregnancy of the two groups （P＞0.05）.Conclusion] In gestational diabetic pregnant women during pregnancy,hyperlipidemia was character of lipid metabolism during pregnancy.Active diet treatment was helpful to control the level of glucose,but no effect on controling the triglycerides level in our study.