摘要
目的探讨基于静息能量消耗(REE)计算每日总能量消耗(TEE),对孕前超重/肥胖的妊娠期糖尿病(GDM)孕妇血糖管理意义。方法选择2018年6月至2019年6月,于首都医科大学附属北京潞河医院产科“糖尿病一日门诊”就诊时,被诊断为孕前超重/肥胖的67例GDM孕妇为研究对象。按照其首次就诊时间的奇、偶周,将其分为研究组(n=34,首次就诊时间为奇数周者)和对照组(n=33,首次就诊时间为偶数周者)。采用成组t检验对2组孕妇年龄、孕次、孕期体重增加值、新生儿出生体重、空腹血糖、餐后2 h血糖等进行统计学分析。采用Mann-Whitney U检验对2组孕妇分娩孕龄、产次等进行统计学分析。采用χ^2检验、Fisher确切概率法、连续性校正χ^2检验对2组孕妇尿酮体阳性率、巨大儿发生率等进行统计学分析。本研究经首都医科大学附属北京潞河医院医学伦理委员审核批准(审批文号:2018-LHKY-027-02),并与所有受试者签署知情同意书。结果①2组GDM孕妇年龄、孕次、产次、分娩孕龄及孕前人体质量指数(BMI)构成比比较,差异均无统计学意义(P>0.05)。②研究组孕妇TEE为(1532.6±301.9)kcal/d,显著低于对照组的(1824.1±313.2)kcal/d,并且差异有统计学意义(t=3.311、P=0.002);2组孕妇血糖达标情况构成比比较,差异亦有统计学意义(P=0.040)。③研究组孕妇孕期体重增加值、糖化血红蛋白(HbA1c)水平和新生儿出生体重分别为(13.4±6.2)kg、(5.6±0.3)%和(3287.5±577.1)g,明显低于对照组的(18.2±4.8)kg、(6.2±0.2)%和(3632.8±490.6)g,并且差异均有统计学意义(t=2.235、P=0.031,t=2.882、P=0.047,t=2.121、P=0.039)。结论基于REE估算的TEE,较通用系数法估算的TEE,更接近于孕前超重/肥胖GDM孕妇的实际能量需求。因此,基于REE估算的TEE更有利于对孕前超重/肥胖的GDM进行孕期血糖管理。
Objective To explore effect of calculating everyday total energy expenditure(TEE)based on resting energy expenditure(REE)on blood glucose management of pregnant women with gestational diabetes mellitus(GDM)who were overweight/obese before pregnancy.Results From June 2018 to June 2019,67 GDM pregnant women who were overweight/obese before pregnancy were selected into this study.According to the odd and even weeks of outpatient treatment,they were divided into study group(n=34,pregnant women who first outpatient treatment in odd weeks of a calendar)and control group(n=33,pregnant women who first outpatient treatment in even weeks of a calendar).Among age,gravidity,weight gain during pregnancy,neonatal birth weight,fasting blood glucose and postprandial 2 h blood glucose between two groups were statistically analyzed by independent-samples t test.Mann-Whitney U test was used to analyze gestational age and parity.Chi-square test,continuity correction of chi-square test or Fisher′s exact test were used to statistically analyze positive rate of urine ketone and incidence of macrosomia.The procedures followed in this study was in accordance with the ethical standards established by the Human Beings Test Committee of Beijing Luhe Hospital Affiliated Capital Medical University,and was approved by the committee(Approval No.2018-LHKY-027-02).Informed consent was obtained from each participate.Results①There were no significant differences in age,gravidity,parity,gestational age of delivery and constituent ratio of BMI before pregnancy between two groups(P>0.05).②TEE of pregnant women in study group[(1532.6±301.9)kcal/d]was significantly lower than that in control group[(1824.1±313.2)kcal/d],and the difference was statistically significant(t=3.311,P=0.002).There was also a significant difference between two groups in composition ratio of blood sugar reaching the standard(P=0.040).③The weight gain during pregnancy,glycosylated hemoglobin,HbcAl level and neonatal birth weight in study group were(13.4±6.2)kg,(5.6±0.3
作者
赵秀伶
高洁
马唯
田丹
姜珊
Zhao Xiuling;Gao Jie;Ma Wei;Tian Dan;Jiang Shan(Department of Obstetrics,Beijing Luhe Hospital Affiliated Capital Medical University,Beijing 101100,China;Department of Nutrition,Beijing Luhe Hospital Affiliated Capital Medical University,Beijing 101100,China)
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2020年第4期451-458,共8页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
北京市通州区科技计划项目(KJ2018CX009-07)。
关键词
能量摄取
能量消耗
总能量消耗
静息能量消耗
超重/肥胖育龄女性
孕前
糖尿病
妊娠
血糖
孕妇
Energy intake
Energy metabolism
Total energy expenditure
Resting energy expenditure
Preconception overweight/obese reproductive woman
Diabetes,gestational
Blood glucose
Pregnant women
