目的探讨饮食和运动干预对妊娠期糖尿病(GDM)患者母婴妊娠结局及血浆脂联素、瘦素的影响。方法选取2014年1月至2015年1月在中煤一公司岭北职工医院确诊为GDM的患者84例,根据随机数字表法分为观察组和对照组,各42例。对照组给予常规孕前...目的探讨饮食和运动干预对妊娠期糖尿病(GDM)患者母婴妊娠结局及血浆脂联素、瘦素的影响。方法选取2014年1月至2015年1月在中煤一公司岭北职工医院确诊为GDM的患者84例,根据随机数字表法分为观察组和对照组,各42例。对照组给予常规孕前指导及宣教,观察组在孕期12周开始对其实施饮食和运动干预,并至分娩结束。记录两组患者的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、体质指数(BMI)、脂联素、瘦素的变化及妊娠结局的差异。结果观察组干预后FPG、2 h PG、FINS、HOMA-IR、BMI、瘦素水平显著低于对照组[(5.02±0.68)nmol/L比(7.70±0.38)nmol/L;(7.1±1.7)nmol/L比(9.2±1.2)nmol/L;(11.2±2.5)m U/L比(17.2±3.0)m U/L;2.8±1.2比3.7±1.0;(26.0±1.7)kg/m2比(27.4±1.7)kg/m2;(8.0±1.8)μg/L比(13.8±1.8)μg/L](P<0.01),而脂联素水平高于对照组[(12.5±1.0)g/L比(11.0±1.4)g/L](P<0.01)。观察组妊娠期高血压、羊水过多、剖宫产率、胎儿窘迫、巨大儿、早产、新生儿窒息的发生率显著低于对照组[2.4%(1/42)比19.0%(8/42),0%比16.7%(7/42),23.8%(10/42)比57.1%(24/42),4.8%(2/42)比23.8%(10/42),4.8%(2/42)比21.4%(9/42),2.4%(1/42)比21.4%(9/42),0%比16.7%(7/42)](P<0.05)。结论早期饮食及运动干预能有效降低GDM患者血糖、脂联素、瘦素水平,改善患者胰岛素抵抗,并能有效改善妊娠结局,降低母婴并发症发生率。展开更多
Non-alcoholic fatty liver disease (NAFLD) comprising hepatic steatosis,non-alcoholic steatohepatitis (NASH),and progressive liver fibrosis is considered the most common liver disease in western countries.Fatty liver i...Non-alcoholic fatty liver disease (NAFLD) comprising hepatic steatosis,non-alcoholic steatohepatitis (NASH),and progressive liver fibrosis is considered the most common liver disease in western countries.Fatty liver is more prevalent in overweight than normal-weight people and liver fat positively correlates with hepatic insulin resistance.Hepatic steatosis is regarded as a benign stage of NAFLD but may progress to NASH in a subgroup of patients.Besides liver biopsy no diagnostic tools to identify patients with NASH are available,and no effective treatment has been established.Visceral obesity is a main risk factor for NAFLD and inappropriate storage of triglycerides in adipocytes and higher concentrations of free fatty acids may add to increased hepatic lipid storage,insulin resistance,and progressive liver damage.Most of the adipose tissue-derived proteins are elevated in obesity and may contribute to systemic inflammation and liver damage.Adiponectin is highly abundant in human serum but its levels are reduced in obesity and are even lower in patients with hepatic steatosis or NASH.Adiponectin antagonizes excess lipid storage in the liver and protects from inflammation and fibrosis.This review aims to give a short survey on NAFLD and the hepatoprotective effects of adiponectin.展开更多
文摘目的探讨饮食和运动干预对妊娠期糖尿病(GDM)患者母婴妊娠结局及血浆脂联素、瘦素的影响。方法选取2014年1月至2015年1月在中煤一公司岭北职工医院确诊为GDM的患者84例,根据随机数字表法分为观察组和对照组,各42例。对照组给予常规孕前指导及宣教,观察组在孕期12周开始对其实施饮食和运动干预,并至分娩结束。记录两组患者的空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、体质指数(BMI)、脂联素、瘦素的变化及妊娠结局的差异。结果观察组干预后FPG、2 h PG、FINS、HOMA-IR、BMI、瘦素水平显著低于对照组[(5.02±0.68)nmol/L比(7.70±0.38)nmol/L;(7.1±1.7)nmol/L比(9.2±1.2)nmol/L;(11.2±2.5)m U/L比(17.2±3.0)m U/L;2.8±1.2比3.7±1.0;(26.0±1.7)kg/m2比(27.4±1.7)kg/m2;(8.0±1.8)μg/L比(13.8±1.8)μg/L](P<0.01),而脂联素水平高于对照组[(12.5±1.0)g/L比(11.0±1.4)g/L](P<0.01)。观察组妊娠期高血压、羊水过多、剖宫产率、胎儿窘迫、巨大儿、早产、新生儿窒息的发生率显著低于对照组[2.4%(1/42)比19.0%(8/42),0%比16.7%(7/42),23.8%(10/42)比57.1%(24/42),4.8%(2/42)比23.8%(10/42),4.8%(2/42)比21.4%(9/42),2.4%(1/42)比21.4%(9/42),0%比16.7%(7/42)](P<0.05)。结论早期饮食及运动干预能有效降低GDM患者血糖、脂联素、瘦素水平,改善患者胰岛素抵抗,并能有效改善妊娠结局,降低母婴并发症发生率。
基金Supported by The Faculty of Medicine of the University of Regensburg (ReForM C)The Deutsche Forschungsgemein-schaft
文摘Non-alcoholic fatty liver disease (NAFLD) comprising hepatic steatosis,non-alcoholic steatohepatitis (NASH),and progressive liver fibrosis is considered the most common liver disease in western countries.Fatty liver is more prevalent in overweight than normal-weight people and liver fat positively correlates with hepatic insulin resistance.Hepatic steatosis is regarded as a benign stage of NAFLD but may progress to NASH in a subgroup of patients.Besides liver biopsy no diagnostic tools to identify patients with NASH are available,and no effective treatment has been established.Visceral obesity is a main risk factor for NAFLD and inappropriate storage of triglycerides in adipocytes and higher concentrations of free fatty acids may add to increased hepatic lipid storage,insulin resistance,and progressive liver damage.Most of the adipose tissue-derived proteins are elevated in obesity and may contribute to systemic inflammation and liver damage.Adiponectin is highly abundant in human serum but its levels are reduced in obesity and are even lower in patients with hepatic steatosis or NASH.Adiponectin antagonizes excess lipid storage in the liver and protects from inflammation and fibrosis.This review aims to give a short survey on NAFLD and the hepatoprotective effects of adiponectin.
