高纤维素饮食对妊娠期糖尿病患者血糖和血脂的影响

摘要

Objective To investigate the effect of high fiber diet approach on glucose tolerance and lipid profiles in pregnant women with GDM. Methods By randomized controlled clinical study, 200 women diagnosed with GDM at 24–28 weeks of gestation in Xingning maternal and children hospital from June 2014 to December 2014 were selected, and randomly allocated into a study group and a control group, 100 cases in each, received medical nutrition therapy combined High Roughage Diet(HRD) and medical nutrition therapy for 8 weeks respectively. The medical nutrition therapy was designed to contain 45%-55% carbohydrates, 15%-20% protein and 25%-30% total fat. The study group further received oral intake of fiber 30g three times a day. Fasting blood samples were taken at baseline and after 4 weeks of intervention to measure fasting plasma glucose, glycated Hb (HbA1C) triglyceride(TG),total cholesterol (TC), Low-density lipoprotein(LDL) and High-density lipoprotein(LDL). Results Adherence to the fiber eating pattern, glucose tolerance such that plasma glucose levels reduced at 1 hour and 2 hour and reduced HbA1c levels between the two groups were significantly different(P < 0.05), however, fasting plasma glucose between the two groups had no significant difference. Fiber addition decreased LDL, TC and TG levels compared with the control diet, they were significantly different between the two diets(P<0.05), however, there was no significantly different between the two diets for HDL level. Conclusion Consumption of the fiber pattern among pregnant women with GDM resulted in beneficial effects on glucose tolerance and lipid profiles compared with the control diet. The high fiber diet is effective in treating constipation during pregnancy.%目的：探讨高纤维素饮食对妊娠期糖尿病（GDM）患者血糖和血脂的影响。方法采取随机对照临床研究，选取2014年6~12月在广东省兴宁市妇幼保健院孕24~28周诊断为GDM的患者200例，随机分为研究组（n=100）和对照组（n=100）分别接受医学营养治疗+高纤维素饮食和医学营养治疗8周。医学营养治疗每日饮食遵从50%~60%碳水化合物、15%~20%蛋白质和25%~30%脂肪的摄入标准。研究组患者饮食在对照组基础上添加麦麸30g tid。分别在治疗前、饮食干预4周后检测空腹血糖和检测餐后1h血糖、餐后2h血糖、糖化血红蛋白（HbA1C）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）水平。结果研究组和对照组相比，餐后1h血糖、餐后2h血糖、HbA1C显著降低，两组比较差异有统计学意义（P＜0.05），两组空腹血糖比较差异无统计学意义（P＞0.05）；研究组和对照组相比，LDL、TC和TG显著降低，差异有统计学意义（P＜0.05）；两组HDL比较差异无统计学意义（P＞0.05）。结论在GDM饮食中添加高纤维素可以显著改善GDM患者的血糖和血脂水平。