摘要目的 研究低血糖指数(GU谷物对妊娠期糖尿病(GDM)孕妇代谢组学及妊娠结局的影响,探讨其对妊娠糖尿病的防治作用机制,为制定营养干预措施提供依据.方法 将确诊为GDM的孕妇按随机数字法分组,31例为低GI谷物治疗组,营养干预12周;31例为病例对照组;另选取30例健康孕妇为正常对照组.孕36周时,采用基于1H-NMR的方法进行血清代谢组学检测、孕妇分娩后统计妊娠结局,对收集的数据进行组间比较和相关影响因素分析.结果 代谢组学研究发现15种与GDM相关的潜在生物标志物,营养干预12周后,低GI谷物治疗组与病例对照组相比差异有统计学意义(P＜0.05),且接近健康孕妇水平,与正常对照组比较差异无统计学意义(P＞0.05).低GI谷物治疗组孕妇剖宫产率、孕期增重、分娩时糖化血红蛋白值、HbA1C、新生儿出生体质量均显著低于病例对照组(P＜0.05).多元线性回归分析结果显示,低GI谷物饮食、HbA1C和血糖是影响GDM孕妇代谢产物的主要因素(P＜0.05).结论 低GI谷物营养治疗能够明显改善GDM孕妇的妊娠结局,可能通过调节相关的生物标志物发挥作用,为进一步探索GDM病因、疗效的作用机制及个体化医学营养治疗策略提供了依据.

abstractsObjective To investigate the effects of low GI cereals on metabolomics and pregnancy outcomes in women with gestational diabetes mellitus (GDM),in order to explore the preventive and therapeutic mechanisms and provide the basis for nutritional interventions.Metbods Pregnant women with gestational diabetes were assigned to the treatment group (n=31),using low GI grains 12 weeks for nutrition intervention and the control group (n =31) according to the random digital table method;30 healthy pregnant women were enrolled as normal control group.At 36th gestational week serum was analyzed by 1H-NMR metabolomics approach.Pregnancy outcomes were gathered for statistics after delivery.Comparison among groups and related influencing factors analysis were conducted.Results After nutritional intervention for 12 weeks,there were statistically significant differences in 15 potential biomarkers associated with gestational diabetes between the treatment group and the control group (P＜0.05),and no statistically significant difference between the treatment group and the normal control group (P＞0.05),that was the pregnant women in the treatment group were close to normal pregnant women.Cesarean rate,gestational weight gain,glycosylated hemoglobin during delivery,fasting insulin and newborn birth weight were significantly lower in the treatment group than in the control group.Multiple linear regression analysis showed that the GI of diet,fasting insulin and blood glucose were influencing factors for metabolomics in women with GDM.Conclusions Using low GI cereals intervention treatments,the pregnancy outcomes of GDM are improved distinctly with the possible mechanisms as adjusting the related biomarkers.Our study provides evidences for further exploring etiology and the therapeutic mechanisms of GDM,and individualized medical nutrition treatment strategy.