Department of Obstetrics, Tangshan Central Hospital, Tangshan, Hebei, China.
Department of Obstetrics and Gynaecology, Jingxing County Hospital, Shijiazhuang, Hebei, China.
Medicine (Baltimore). 2023 Oct 20;102(42):e35498. doi: 10.1097/MD.0000000000035498.
To analyze the effects of dietary intervention combined with insulin aspart on the serum levels of nesfatin-1, C1q/TNF related protein-12 (CTRP12), and pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). In this retrospective cohort study, 513 women with GDM admitted to Tangshan Central Hospital (Tangshan, China) between January 2019 and December 2022 were selected and divided into an observation group (dietary intervention combined with insulin aspart therapy; n = 284) and a control group (insulin aspart therapy, n = 229). The general characteristics, clinical outcomes, serum nesfatin-1 and CTRP12 levels, 2-hour postprandial blood glucose levels, pregnancy outcomes, and perinatal outcomes of the 2 groups were compared. After treatment, the total effective rate in the observation group was significantly higher than that of the control group (97.54% vs 86.03%, respectively; P < .001). Compared with the pretreatment levels, nesfatin-1 and CTRP12 levels were decreased in both groups; nesfatin-1 and CTRP12 levels in the observation group were significantly higher than those in the control group. After treatment, the preprandial and 2-hour postprandial blood glucose levels in the observation group were significantly lower than those in the control group. Compared with the control group, the observation group had significantly fewer cesarean sections, and a significantly lower incidence of postpartum hemorrhage, premature rupture of membranes, and other adverse pregnancy outcomes. After treatment, the risks of preterm birth, macrosomia, fetal distress, neonatal asphyxia, neonatal hypoglycemia, and other adverse perinatal outcomes were significantly lower in the observation group than in the control group. In pregnant women with GDM, dietary intervention combined with insulin aspart can improve clinical outcomes; reduce nesfatin-1, CTRP12, and blood glucose levels; and reduce the incidence of adverse pregnancy outcomes.
分析饮食干预联合门冬胰岛素对妊娠期糖尿病（GDM）孕妇血清神经肽 Y/生糖素相关肽 1 （nesfatin-1）、C1q/肿瘤坏死因子相关蛋白 12（CTRP12）水平及妊娠结局的影响。
采用回顾性队列研究方法，选取 2019 年 1 月至 2022 年 12 月在唐山市中心医院（唐山）收治的 513 例 GDM 孕妇，按照治疗方法的不同分为观察组（饮食干预联合门冬胰岛素治疗，284 例）和对照组（门冬胰岛素治疗，229 例）。比较两组患者的一般资料、临床结局、血清 nesfatin-1 和 CTRP12 水平、餐后 2 h 血糖水平、妊娠结局和围生结局。
观察组患者的总有效率为 97.54%，高于对照组的 86.03%（P <.001）。两组患者治疗后血清 nesfatin-1 和 CTRP12 水平均较治疗前降低，且观察组均高于对照组。观察组患者治疗后餐前及餐后 2 h 血糖水平均低于对照组。观察组患者的剖宫产率低于对照组，产后出血、胎膜早破等不良妊娠结局发生率低于对照组。观察组患者的早产、巨大儿、胎儿窘迫、新生儿窒息、新生儿低血糖等不良围生结局发生率均低于对照组。
饮食干预联合门冬胰岛素可改善 GDM 孕妇的临床结局，降低 nesfatin-1、CTRP12 及血糖水平，减少不良妊娠结局的发生。
