协和医学杂志

2015, v.6(04) 246-250

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妊娠糖尿病营养相关危险因素病例对照研究
Nutrition-related Risk Factors for Gestational Diabetes Mellitus: a Case-control Study

李春微;于康;马良坤;李融融;王晓纯;
LI Chun-wei;YU Kang;MA Liang-kun;LI Rong-rong;WANG Xiao-chun;Department of Clinical Nutrition,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Nutrition,Peking New Century International Healthcare System;

摘要(Abstract):

目的探讨妊娠糖尿病(gestational diabetes mellitus,GDM)营养相关危险因素,为孕期合理膳食及健康管理提供依据。方法纳入2014年12月至2015年5月就诊于北京协和医院产科且在孕24~28周完成糖耐量筛查的25~45岁孕妇。采取多阶段连续等比例抽样,确诊GDM新发病例150例为病例组,同期就诊非GDM 150例为对照组。利用食物频率问卷对其一般情况及膳食状况进行调查。采用Logistic回归筛选GDM营养相关危险因素。结果单因素分析显示,2型糖尿病家族史、孕前体重指数(body mass index,BMI)、GDM史、水果摄入量、精制谷物所占比例、每日肉类摄入量、高脂食品摄入频率、每日食盐摄入量、每日烹调油摄入量、每日坚果摄入量、在外就餐频率、含糖饮料摄入及体力活动状况与GDM之间相关性具有统计学意义(P<0.05)。多因素Logistic回归分析显示,孕前BMI(OR=1.628,95%CI:1.079~2.456)、2型糖尿病家族史(OR=1.761,95%CI:1.001~3.096)、GDM史(OR=7.855,95%CI:1.982~31.125)、水果摄入量(OR=1.457,95%CI:1.148~1.849)、精制谷物(OR=1.350,95%CI:1.008~1.808)、高脂食品(OR=1.398,95%CI:1.066~1.833)及缺乏体力活动(OR=1.257,95%CI:1.111~1.422)与GDM具有相关性(P<0.05)。结论孕前BMI异常、2型糖尿病家族史、GDM史、水果摄入过量、主食过于精制、经常摄入高脂食品及缺乏体力活动可增加GDM发病风险。
Objective To identify nutrition-related risk factors for gestational diabetes mellitus( GDM),so as to provide guidance for improvement of maternal nutrition and health management. Methods Subjects were selected with multi-stage continuous proportionate sampling from the women who visited Department of Obstetrics of Peking Union Medical College Hospital and received glucose tolerance test in 24-28 gestational weeks during the period from December 2014 to May 2015. A total of 150 confirmed GDM cases were enrolled,and 150non-GDM gravida were selected into control group. General condition and dietary status of the GDM group and the control group were investigated using a food frequency questionnaire( FFQ). Nutrition-related risk factors for GDM were identified using Logistic regression analysis. Results Univariate analysis showed that GDM was significantly associated with family history of type 2 diabetes mellitus,preconception body mass index( BMI),histo-ry of GDM,fruits intake,proportion of refined grains,daily meat intake,frequency of high fat diet consumption,daily salt intake,daily oil intake,daily nuts intake,frequency of eating out,consumption of sugary drinks,and physical activity( P < 0. 05). Multivariate Logistic regression analysis indicated that preconception BMI( OR =1. 628,95% CI: 1. 079- 2. 456),family history of type 2 diabetes mellitus( OR = 1. 761,95% CI: 1. 001-3. 069),history of GDM( OR = 7. 855,95% CI: 1. 982- 31. 125),fruits intake( OR = 1. 457,95% CI:1. 148- 1. 849),refined grains( OR = 1. 350,95% CI: 1. 008- 1. 808),high fat diet( OR = 1. 398,95%CI: 1. 066- 1. 833),and physical inactivity( OR = 1. 257,95% CI: 1. 111- 1. 422) were related to GDM( P < 0. 05). Conclusions High preconception BMI,family history of type 2 diabetes mellitus,history of GDM,over intake of fruits,high proportion of refined grains,frequent intake of high fat diet,and physical inactivity may increase the risk of GDM.

关键词(KeyWords): 妊娠糖尿病;营养相关危险因素;膳食调查;病例对照研究
gestational diabetes mellitus;nutrition-related risk factors;dietary survey;case-control study

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作者(Author): 李春微;于康;马良坤;李融融;王晓纯;
LI Chun-wei;YU Kang;MA Liang-kun;LI Rong-rong;WANG Xiao-chun;Department of Clinical Nutrition,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Nutrition,Peking New Century International Healthcare System;

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