妊娠期糖尿病患者孕中期骨密度情况及影响因素分析

目的分析妊娠糖尿病(gestational diabetes mellitus,GDM)患者孕中期骨密度的潜在影响因素,为临床妊娠期妇女骨密度干预方案提供参考依据。方法选取200名孕24～26周GDM患者进行膳食、生活习惯、骨质疏松家族史、膳食补充剂服用等情况的问卷调查,并进行身高、体重、骨密度情况及生化指标检查。结果骨质疏松组GDM患者深绿色蔬菜摄入高于GDM患者;而浅绿色及浅色蔬菜、红橙黄色蔬菜、奶、豆类食物及复合型营养素的摄入均低于对照组GDM患者;多因素Logistic回归分析显示深绿色蔬菜过多,浅色及浅绿色及红橙黄色蔬菜、鱼虾类水产品、奶豆制品的摄入过少及未补充复合营养补充剂均有可能是骨质疏松组GDM患者孕中期骨密度的危险因素。骨质疏松组GDM患者空腹血糖、糖化血红蛋白、及碱性磷酸酶水平均高于对照组GDM患者,白蛋白、视黄醇结合蛋白均低于对照组GDM患者。结论浅绿色及浅色蔬菜、红橙黄色蔬菜、奶及豆制品,复合型营养素的摄入均对孕中期GDM患者骨密度起到保护作用,而深绿色蔬菜摄入过量可能会对孕中期GDM患者骨密度起到不良作用。

Analysis of Influencing factors of bone mineral density in patients with gestational diabetes mellitus during the second trimester of pregnancy

Objective To analyze the potential influencing factors of bone mineral density(BMD) in gestational diabetes mellitus (GDM) patients during the second trimester of pregnancy, and to provide reference for clinical intervention programs of BMD in pregnant women. Methods According to the purpose of the study, 200 pregnant women with diabetes mellitus from 24 to 26 weeks of gestation were investigated by questionnaires on diet, living habits, family history of osteoporosis and dietary supplements, and their height, weight, bone mineral density and biochemical indicators were examined. Results The intake of dark green vegetables in osteoporosis group was higher than that in normal bone group (P < 0.05), while the intake of light green vegetables, red-orange-yellow vegetables, milk, legumes and complex nutrients in osteoporosis group was lower than that in normal bone group (P < 0.05).The results of multivariate logistic regression analysis were the same as former results. The levels of fasting blood sugar, glycosylated hemoglobin and alkaline phosphatase in osteoporosis group were higher than those in normal bone group (P < 0.05), while those in white bone group (P < 0.05). Protein and retinol binding protein were lower than those in normal bone GDM group (P < 0.05). Conclusion Light green vegetables, red and orange vegetables, milk and soybean products, the intake of complex nutrients all can protect the bone mineral density of patients with GDM in the second trimester., while excessive intake of dark green vegetables may have a negative effect on bone mineral density of GDM patients in the second trimester.