李春微, 于康, 马良坤, 李融融, 王晓纯. 妊娠糖尿病营养相关危险因素病例对照研究[J]. 协和医学杂志, 2015, 6(4): 246-250. DOI: 10.3969/j.issn.1674-9081.2015.04.002
引用本文: 李春微, 于康, 马良坤, 李融融, 王晓纯. 妊娠糖尿病营养相关危险因素病例对照研究[J]. 协和医学杂志, 2015, 6(4): 246-250. DOI: 10.3969/j.issn.1674-9081.2015.04.002
Chun-wei LI, Kang YU, Liang-kun MA, Rong-rong LI, Xiao-chun WANG. Nutrition-related Risk Factors for Gestational Diabetes Mellitus: a Case-control Study[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(4): 246-250. DOI: 10.3969/j.issn.1674-9081.2015.04.002
Citation: Chun-wei LI, Kang YU, Liang-kun MA, Rong-rong LI, Xiao-chun WANG. Nutrition-related Risk Factors for Gestational Diabetes Mellitus: a Case-control Study[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(4): 246-250. DOI: 10.3969/j.issn.1674-9081.2015.04.002

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

  • 摘要:
      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。

     

    Abstract:
      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 150 non-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), history 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.

     

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