摘要
目的分析糖脂代谢情况对妊娠期糖尿病(GDM)患者泌乳情况的影响,探讨具体营养干预对策。方法本文为回顾性研究,病例纳入修武县人民医院2021年1月至2022年12月收治的112例GDM患者,根据产后泌乳情况,将52例存在产后泌乳启动延迟(DOL)的患者列为病例组,将其余60例正常泌乳患者列为对照组,归纳导致GDM患者发生DOL的危险因素,分析糖脂代谢水平与DOL的相关性;根据研究结果,并探讨具体营养干预对策。结果妊娠期体质指数(BMI)≥28 kg/m^(2)、孕期体质量增长值≥5 kg、初产妇、剖宫产、空腹血糖(FBG)≥10 mmol/L、餐后2 h血糖(2h PG)≥13 mmol/L、糖化血红蛋白(HbA1c)≥10%、甘油三酯(TG)≥2.50 mmol/L、总胆固醇(TC)≥6.45 mmol/L、高密度脂蛋白胆固醇(HDL-C)≤1.80 mmol/L、低密度脂蛋白胆固醇(LDL-C)≥2.0 mmol/L、载脂蛋白A5(ApoA5)≤100μg/L、C1q/肿瘤坏死因子相关蛋白6(CTRP6)≥600μg/L、缺乏系统母乳喂养指导为导致GDM发生DOL的危险因素。DOL发生率与FBG、2h PG、HbA1c、TG、TC、LDL-C、CTRP6呈正相关,与HDL-C、ApoA5呈负相关。结论超重或肥胖的初产妇经剖宫产分娩后发生DOL的风险更高,其发生率与糖脂代谢功能密切相关,对患者营养状况进行全面评估、予以个体化营养管理并做好相应母乳喂养指导对防治DOL、提高母乳喂养率均有积极意义。
Objective To analyze the impact of glucose and lipid metabolism on lactation in gestational diabetes mellitus(GDM)patients and explore specific nutritional intervention strategies.Methods A total of 112 GDM patients admitted to Xiuwu County People′s Hospital from January 2021 to December 2022 were included in this retrospective study.According to postpartum lactation,52 patients with delayed postpartum lactation initiation(DOL)were classified as the case group,and the remaining 60 patients with normal lactation were classified as the control group.The risk factors leading to DOL in GDM patients were summarized,and the correlation between glycolipid metabolism and DOL was analyzed.The specific nutritional intervention strategies were discussed.Results Pregnancy BMI≥28 kg/m^(2),pregnancy weight gain value≥5 kg,primipara,cesarean section,fasting blood glucose(FBG)≥10 mmol/L,2h postprandial blood glucose(2h PG)≥13 mmol/L,glycated hemoglobin(HbA1c)≥10%,triglyceride(TG)≥2.50mmol/L,total cholesterol(TC)≥6.45 mmol/L,high-density lipoprotein cholesterol(HDL-C)≤1.80 mmol/L,low-density lipoprotein cholesterol(LDL-C)≥2.0 mmol/L,ApoA5≤100μg/L,C1q/tumor necrosis factor associated protein 6(CTRP6)≥600μg/L,and lack of systematic breastfeeding guidance were the risk factors for DOL in GDM.The incidence of DOL was positively correlated with FBG,2h PG,HbA1c,TG,TC,LDL-C,and CTRP6,and negatively correlated with HDL-C and ApoA5.Conclusion Overweight or obese primiparous women have a higher risk of DOL after delivery after Caesarean section,and its incidence is closely related to the function of glucose and lipid metabolism.A comprehensive assessment of the patient′s nutritional status,individualized nutrition management,and corresponding breastfeeding guidance are of positive significance to prevent DOL and improve the rate of breastfeeding.
作者
周晶
Zhou Jing(Department of Obstetrics,Xiuwu County People′s Hospital,Jiaozuo 454350,China)
出处
《山西医药杂志》
CAS
2024年第10期727-731,共5页
Shanxi Medical Journal
基金
河南省医学科技攻关项目(LHGJ202102131)。
关键词
糖尿病
妊娠
泌乳启动延迟
相关性分析
糖脂代谢
营养干预
Diabetes,gestational
Delayed lactation initiation
Correlation analysis
Glycolipid metabolism
Nutritional intervention
