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强化低升糖负荷饮食干预对妊娠期糖尿病女性血糖和血脂的管理:一项随机对照试验。

Intensive low-glycaemic-load dietary intervention for the management of glycaemia and serum lipids among women with gestational diabetes: a randomized control trial.

作者信息

Ma Wen-Jun, Huang Zhi-Hong, Huang Bi-Xia, Qi Ben-Hua, Zhang Yan-Jun, Xiao Ben-Xi, Li Yuan-Hong, Chen Li, Zhu Hui-Lian

机构信息

1Guangdong General Hospital,Guangdong Academy of Medical Science,Guangzhou,People's Republic of China.

2Faculty of Nutrition,School of Public Health,Sun Yat-sen University,74th Zhongshan II Road,Guangzhou 510080,People's Republic of China.

出版信息

Public Health Nutr. 2015 Jun;18(8):1506-13. doi: 10.1017/S1368980014001992. Epub 2014 Sep 15.

Abstract

OBJECTIVE

The present study aimed to compare the effects of a general dietary intervention and an intervention with low glycaemic load (GL) on glycaemic control, blood lipid metabolism and pregnancy outcomes in women with gestational diabetes mellitus.

DESIGN

Participants were randomly assigned to two groups, receiving either an individualized general dietary intervention (Control group) or an intensive low-GL intervention (Low-GL group) every two weeks, from 24-26 weeks of gestation to delivery.

SETTING

The Center of Maternal Primary Care in Guangdong General Hospital, China.

SUBJECTS

Ninety-five women with gestational diabetes mellitus were enrolled from June 2008 to July 2009.

RESULTS

After the intervention, both groups significantly decreased their dietary intakes of energy, fat and carbohydrate. The Low-GL group had significantly lower values for GL (122 v. 136) and glycaemic index (50 v. 54) but greater dietary fibre intake (33 v. 29 g/d) than did the Control group (all P<0·01). Significantly greater decreases in fasting plasma glucose (-0·33 v. -0·02 mmol/l, P<0·01) and 2 h postprandial glucose (-2·98 v. -2·51 mmol/l, P<0·01), significantly lower increases in total cholesterol (0·12 v. 0·23 mmol/l) and TAG (0·41 v. 0·56 mmol/l) and a significantly lower decrease in HDL cholesterol (-0·01 v. -0·11 mmol/l) were also observed in the Low-GL group compared with the Control group (all P<0·05). There were no significant differences in body weight gain, birth weight or other maternal-fetal perinatal outcomes between the two groups.

CONCLUSIONS

The low-GL targeted dietary intervention outperformed the general dietary intervention in glycaemic control and the improvement of blood lipid levels in women with gestational diabetes mellitus.

摘要

目的

本研究旨在比较一般饮食干预和低血糖负荷(GL)干预对妊娠期糖尿病女性血糖控制、血脂代谢及妊娠结局的影响。

设计

参与者被随机分为两组,从妊娠24 - 26周直至分娩,每两周接受一次个体化的一般饮食干预(对照组)或强化低GL干预(低GL组)。

地点

中国广东省人民医院孕产妇初级保健中心。

研究对象

2008年6月至2009年7月招募了95名妊娠期糖尿病女性。

结果

干预后,两组的能量、脂肪和碳水化合物饮食摄入量均显著降低。低GL组的GL值(122对136)和血糖指数(50对54)显著低于对照组,但膳食纤维摄入量(33对29克/天)高于对照组(均P<0.01)。与对照组相比,低GL组空腹血糖(-0.33对-0.02毫摩尔/升,P<0.01)和餐后2小时血糖(-2.98对-2.51毫摩尔/升,P<0.01)显著降低,总胆固醇(0.12对0.23毫摩尔/升)和甘油三酯(0.41对0.56毫摩尔/升)显著升高幅度更低,高密度脂蛋白胆固醇降低幅度(-0.01对-0.11毫摩尔/升)也显著更低(均P<0.05)。两组在体重增加、出生体重或其他母婴围产期结局方面无显著差异。

结论

在妊娠期糖尿病女性的血糖控制和血脂水平改善方面,低GL靶向饮食干预优于一般饮食干预。

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