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有氧运动对孕期母体代谢标志物的影响。

The effects of aerobic exercise on markers of maternal metabolism during pregnancy.

机构信息

School of Dental Medicine, Department of Foundational Sciences and Research, East Carolina University (ECU), Greenville, North Carolina, USA.

College of Health and Human Performance, Department of Kinesiology, ECU, Greenville, North Carolina, USA.

出版信息

Birth Defects Res. 2021 Feb 1;113(3):227-237. doi: 10.1002/bdr2.1780. Epub 2020 Aug 16.

Abstract

BACKGROUND

Optimal maternal metabolism during pregnancy is essential for healthy fetal growth and development. Chronic exercise is shown to positively affect metabolism, predominantly demonstrated in nonpregnant populations.

OBJECTIVE

To determine the effects of aerobic exercise on maternal metabolic biomarkers during pregnancy, with expected lower levels of glucose, insulin, and lipids among exercise-trained pregnant women.

METHODS

Secondary data analyses were performed using data from two, longitudinal prenatal exercise intervention studies (ENHANCED by MOM and GESTAFIT). Exercisers completed 150 min of weekly moderate-intensity exercise during pregnancy (24+ weeks) while nonexercisers attended stretching sessions. Pregnant women were 31-33 years of age, predominantly non-Hispanic white, and "normal weight" body mass index. At 16 and 36 weeks of gestation, fasting blood samples were collected via fingerstick and venipuncture. Maternal glucose, insulin, insulin resistance (HOMA-IR), total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and triglycerides (TG) were analyzed. ANCOVA analyses were performed to evaluate the effects of aerobic exercise on markers of maternal metabolism in late pregnancy, controlling for baseline levels.

RESULTS

Our sample included 12 aerobic exercisers and 54 nonexercising control groups. Significant between-groups differences at 16 weeks of gestation were found for TG (92.3 vs. 121.2 mg/dl, p = .04), TC (186.8 vs. 219.6 mg/dl, p = .002), and LDL (104.1 vs. 128.8 mg/dl, p = .002). Aerobic-trained pregnant women exhibited lower insulin levels in late pregnancy (β = -2.6 μIU/ml, 95% CI:-4.2, -0.95, p = .002) and a reduced increase in insulin levels from 16 to 36 week of gestation (β = -2.3 μIU/ml, 95% CI: -4.4, -0.2, p = .034) compared with nonexercising pregnant women. No statistically significant effects were observed for maternal HOMA-IR, TC, LDL, HDL, TC:HDL, and TG in late pregnancy.

CONCLUSIONS

The observations of this study demonstrate that prenatal exercise may positively affect maternal insulin, with aerobic-trained pregnant women exhibiting lower insulin levels in late pregnancy. Additionally, we found no appreciable effects of prenatal exercise on maternal lipids in late pregnancy.

摘要

背景

孕期母体代谢的最佳状态对胎儿的健康生长和发育至关重要。有研究表明,慢性运动对代谢有积极影响,这主要在非孕妇群体中得到证实。

目的

确定有氧运动对孕妇代谢生物标志物的影响,预计运动训练的孕妇的血糖、胰岛素和血脂水平会降低。

方法

使用两项纵向产前运动干预研究(ENHANCED by MOM 和 GESTAFIT)的数据进行二次数据分析。在妊娠 24 周及以后,运动者每周完成 150 分钟的中等强度运动,而非运动者参加伸展运动。孕妇年龄在 31-33 岁,主要为非西班牙裔白人,体重指数正常。在妊娠 16 和 36 周时,通过手指穿刺和静脉穿刺采集空腹血样。分析母体血糖、胰岛素、胰岛素抵抗(HOMA-IR)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)和甘油三酯(TG)。采用协方差分析评估有氧运动对妊娠晚期母体代谢标志物的影响,控制基线水平。

结果

我们的样本包括 12 名有氧运动者和 54 名非运动对照组。在妊娠 16 周时,两组间存在显著差异的指标有 TG(92.3 与 121.2 mg/dl,p =.04)、TC(186.8 与 219.6 mg/dl,p =.002)和 LDL(104.1 与 128.8 mg/dl,p =.002)。与非运动孕妇相比,运动训练的孕妇在妊娠晚期的胰岛素水平较低(β = -2.6 μIU/ml,95%CI:-4.2,-0.95,p =.002),且从妊娠 16 周到 36 周时胰岛素水平的升高幅度也较小(β = -2.3 μIU/ml,95%CI:-4.4,-0.2,p =.034)。在妊娠晚期,孕妇的 HOMA-IR、TC、LDL、HDL、TC:HDL 和 TG 没有观察到统计学显著的影响。

结论

本研究的观察结果表明,产前运动可能对母体胰岛素产生积极影响,运动训练的孕妇在妊娠晚期胰岛素水平较低。此外,我们发现产前运动对妊娠晚期母体血脂没有明显影响。

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