Impacts of Dietary Fat Changes on Pregnant Women with Gestational Diabetes Mellitus: A Randomized Controlled Study

一项随机对照研究：饮食中的脂肪变化对孕妇妊娠期糖尿病的影响

Hui-Yan Wang ； Hong-Yi Jiang ； Li-Ping Yang ； Ming Zhang

《Asia Pacific Journal of Clinical Nutrition》 24卷1期 (2015/03) Pp. 58-64

https://doi.org/10.6133/apjcn.2015.24.1.19

摘要

目的：观察增加植物油中多不饱和脂肪酸的摄入对妊娠期糖尿病孕妇血糖、脂质代谢以及妊娠结局的影响。方法：84例GDM孕妇，孕24~28周，不伴有其他妊娠合并症和并发症，随机分为实验组41例，对照组43例，在总能量和蛋白质摄入量相同情况下，给予实验组多油配餐，对照组为传统少油配餐。结果：饮食干预后，实验组脂肪和三种脂肪酸摄入量和供能比均高于对照组（p＜0.001），实验组多不饱和脂肪酸摄入量和供能比较干预前增加，对照组多不饱和脂肪酸摄入量无改变。两组空腹血糖、餐后2h血糖、胰岛素抵抗指数均较干预前显著降低（p＜0.05），两组的血脂变化一致；两组妊娠结局差异无统计学意义。结论：GDM的饮食治疗只要遵照基本规则，严格控制总能量的摄入，适当增加植物油中多不饱和脂肪酸的摄入对孕妇和胎儿是有益的。

關鍵字

妊娠期糖尿病 ； 膳食结构 ； 植物油 ； 脂肪酸 ； 血脂

並列摘要

Objective: This study aims to determine the impact of increasing polyunsaturated fatty acid intake on blood glucose, lipid metabolism, and pregnancy outcomes of pregnant women with gestational diabetes mellitus. Methods: Under constant total energy and protein intake, 84 pregnant women with gestational diabetes mellitus were randomly divided into the experimental and control groups, which were given oil-rich and conventional low-oil meals, respectively. Results: After the dietary intervention, the intake and energy supply of fat and the three fatty acids were significantly higher in the experimental group than the control group (p＜0.001). The intake and energy supply of polyunsaturated fatty acids increased significantly post-intervention in the experimental group but did not change in the control group. In both the intervention and the control group, fasting blood glucose, 2 h postprandial plasma glucose, and the insulin resistance index decreased significantly post-intervention (p＜0.05); the lipid changes were consistent between groups. Pregnancy outcomes did not differ significantly between the two groups (p＞0.05). Conclusions: An appropriate increase in polyunsaturated fatty acid intake benefits pregnant women with gestational diabetes mellitus as well as fetuses, as long as the diet therapy follows basic recommendations and total energy intake is strictly controlled.

並列關鍵字

gestational diabetes mellitus ； diet structure ； vegetable oil ； fatty acids ； blood lipid