營養素攝取/GNB3 C825T基因多型性與懷孕婦女體重變化之相關性研究

Relations between nutrient intake/GNB3 C825T polymorphism and weight change in pregnant women

蔡佩伶(Pei-Lin Tsai)

指導教授 ： 黃孟娟

共同指導教授 ： 蔡英美

高雄醫學大學/醫學院/醫學研究所/碩士(2006年)

https://doi.org/10.6832/KMU.2006.00114

摘要

在國外許多有關孕婦的研究，探討營養素攝取、體重變化與生產結果之間的相互關係，但針對與肥胖相關基因，探討其對孕婦體重變化之研究卻十分有限。故本研究之目的為探討孕期營養素攝取以及GNB3 C825T基因多型性，與孕婦體重變化以及生產結果之相關性。本研究為一世代追蹤的研究，在民國93年7月1日到95年2月28日利用24小時飲食回憶收集第一及第三孕期之熱量/巨量營養素攝取問卷，並完成追蹤其血液生化值資料、體重變化指標以及DNA的單胞胎孕婦共105名。體重變化之定義為，淨體重增加：產前最後一次測量之體重－懷孕前體重；淨體重增加比例：(產前最後一次測量之體重－懷孕前體重) / 懷孕前體重x 100％。本研究主要結果如下: 孕婦第一期及第三期熱量/巨量營養素之攝取與淨體重增加及淨體重增加比例並無顯著相關。第一孕期及第三孕期能量/巨量營養素攝取與孕婦之生產結果（嬰兒出生體重、出生身長、出生頭圍、出生胸圍及胎盤重）之相關性方面，嬰兒出生身長與第三期蛋白質攝取成正相關(r=0.19，p=0.04)，嬰兒出生頭圍與第一期脂肪攝取呈負相關(r=-0.20，p=0.04)，其餘營養素之攝取則與生產結果不具相關性。另一方面，懷孕婦女之體重變化與生產結果之分析顯示，孕婦懷孕期間淨體重增加與嬰兒出生體重成正相關 (r=0.19，p=0.04)、與嬰兒出生身長成正相關(r=0.22，p=0.02)及胎盤重成正相關(r=0.21，p=0.04)，而懷孕前體重及淨體重增加比例與生產結果則無顯著性相關。GNB3 C825T基因多型性在105位個案中之基因型頻率為CC型：24.8％(n=26)、CT型：52.4％(n=55)及TT型：22.9％(n=24)。懷孕婦女淨體重增加比例，在CC型（22.1%）、CT型（24.4%）與TT型（27.2%）間有顯著差異 (p=0.03)，且進一步根據趨勢分析，其淨體重增加比例與GNB3 C825T CC型、CT型與TT型呈現顯著增加之趨勢 (p for trend= 0.02)。懷孕前平均體重在CC型（57.1kg）、CT型（54.6kg）與TT型（53.3kg）呈現逐漸遞減，而懷孕期平均淨體重在CC型（12.6kg）、CT型(13.1kg)與TT型（14.3kg）則呈現逐漸遞增，但統計上並未達到顯著性相關。GNB3 C825T基因多型性與孕婦之生產結果則無顯著相關。
在本研究中結果發現，懷孕婦女之熱量/巨量營養素攝取與體重增加雖無顯著性相關，但某些營養素攝取與嬰兒出生身長及頭圍具相關性。在未來研究中，欲深入探討熱量/巨量營養素攝取與體重變化及生產結果之相關性，必須考慮飲食回憶之誤差、複合食物之營養素評估及樣本數的增加。而GNB3 C825T基因多型性與孕婦體重變化與生產結果之關係在未來研究中則需要增加樣本數以釐清其相關性。

關鍵字

GNB3 C825T ； 懷孕 ； 熱量/巨量營養素 ； 體重變化 ； 生產結果

並列摘要

There are many studies investigating relations among nutrient intake，weight changes during pregnancy and birth outcomes。 However，very few studies examining associations between obesity-related gene polymorphism and weight changes during pregnancy。The purpose of the current study is to examine associations among energy/macronutrient intake，GNB3 C825T polymorphism，weight chane during pregnancy and birth outcomes。 This is a cohort study。During period of July 1994 ~February 1996。 There were total 105 singlet pregnant women completing the experiment。 The nutrient intake during 1st and 3rd trimesters were collected using 24 hour dietary recall and weight parameters of pregnant women were monitored throughout pregnancy。 Net weight changes (WC) were defined as (weight before pregnancy (kg) – weight (kg) measured before pregnancy)。 % of weight change (PWC) is defined as (weight before pregnancy (kg) – weight (kg) measured before pregnancy)/ weight before pregnancy (kg) * 100%。 No significant associations were found between energy/macronutrient intake in 1st and 3rd trimester and WC or PWC。 There were positive relations between protein intake (g) in 3rd trimester and birth length (r=0.19，p=0.04)；negative associations were found between 1st trimester fat intake and birth head circumference (r=-0.20，p=0.04)。 With regard to relatioships between pregnant-related weight parameters and birth outcome， WC was associated with birth weight (r=0.19，p=0.04)、birth length (r=0.22，p=0.02) and placenta weight (r=0.21，p=0.04)；no assoctions were observed between PWC and the birth outcomes。 The distribution of GNB3 C825T of 105 subjects were CC genotype：24.8％(n=26)、CT genotype：52.4％(n=55) and TT genotype：22.9％(n=24)。There were significant differences in PWC among CC genotype（22.1%）、CT genotype（24.4%）and TT genotype（27.2%）in a dose response manner (p for trend= 0.02)。Prepregnant weight (kg) were decreased（CC=57.1kg，CT=54.6kg，TT=53.3kg）and WC（CC=12.6kg， CT=13.1kg， TT=14.3kg）were decreased among CC genotype， CT genotype and TT genotype accordingly，however，the trends did not reach statistically significant。 No associations were observed between GNB3 C825T gene polymorphism and birth outcomes。To further confirm relationships between nutrient intake weight change during pregnancy， larger sample size may be needed to overcome bias derived from dietary recall。 Further，GNB3 C825T gene polymrophism seems to related to some weight change parameters during pregnancy，increased sample size is also needed to further clarify their associations。

並列關鍵字

GNB3 C825T ； pregnancy ； energy/macronutrient ； weight change ； birth outcome

參考文獻

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