妊娠期糖尿病患者妊娠晚期营养代谢评价的研究

目的：了解妊娠晚期妊娠期糖尿病（GDM）患者的营养代谢状态。方法：回顾性对比年龄、妊娠周数、产次符合要求的148例GDM患者（GDM组）及150例葡萄糖耐量正常（NGT）的妇女（NGT组）。检测指标主要包括：妊娠妇女妊娠期体质量指数（BMI）变化值，血浆白蛋白、总胆固醇、三酰甘油、血钙、肌酐水平以及新生儿体质量。结果：与NGT组相比，GDM组妊娠期BMI增长值较高，两组间差异有统计学意义（t =2.85，P =0.006），而两组间的年龄及妊娠周数差异均无统计学意义。GDM组巨大儿发生率较NGT组增加，差异有统计学意义（P =0.018）。GDM组在血浆白蛋白、三酰甘油以及血钙水平与NGT组存在差异，具有统计学意义（均P ＜0.001），而两组间的总胆固醇及肌酐水平差异均无统计学意义。结论：GDM组存在明显的糖脂代谢异常，妊娠期及早监测体质量及相关生化指标含量变化，对于GDM的治疗及妊娠期营养有重要意义。

Clinical Study of the Nutrition and Metabolism During the Third Trimester of Gestational Diabetes

Objective: This study is aimed to comprehend the nutrition and metabolism state of the gestational diabetes mellitus during the third trimester of pregnancy. Methods: Compare the 148 pregnant women with gestational diabetes mellitus with the 150 normal control patients from the age, gestational age, parity. The main testing indicators include BMI changes in value during pregnancy, serum albumin, total cholesterol, triglycerides, Calcium, creatinine level in blood and the birth weight of the fetal. Results: Compared with normal pregnancy,the increasing in value during pregnancy of the GDM is higher, the difference was statistically significant（t =2.85，P =0.006）, and the differences of the years and weeks in pregnancy are not statistically significant. The probability of the fetal macrosomia in GDM is much higher than in the NGT, which is statistically significant（P ＜0.05）. The level of the serum albumin, triglycerides and Calcium of the GDM are significantly different from the NGT, which are statistically significant（P ＜0.05）. But the total cholesterol and creatinine level in blood between the two groups are not signigicantly different. Conclusions: In gestational diabetes mellitus group there are obvious states in Glucose and lipid metabolism. It is of great significance for the gestational diabetes mellitus treatment and the nutrition during pregnancy to monitoring the changes of weight and the related biochemical indicators.