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目的探讨运动联合饮食干预对妊娠期糖尿病(GDM)患者胰岛素抵抗、血清脂联素和内脂素水平的影响。方法选择2015年1月-2016年12月莱州市妇幼保健院收治的80例GDM患者为研究对象,随机分为观察组和对照组,每组各40例,观察组GDM患者应用运动联合饮食干预,对照组GDM患者仅采用常规性孕期指导,对两组研究患者均在干预前后测定空腹血糖、餐后2 h血糖、胰岛素抵抗指数(HOMA-IR)、血清脂联素、内脂素、甘油三酯、总胆固醇、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)水平,并对比两组患者妊娠结局情况。结果干预前,两组血糖、胰岛素抵抗、血清脂联素、内脂素、甘油三酯、总胆固醇、LDL-C及HDL-C水平比较,差异无统计学意义(P>0.05);干预后,两组各项指标水平比较,差异有统计学意义(P<0.05)。观察组不良妊娠结局人数少于对照组,两组比较,差异有统计学意义(P<0.05)。结论运动联合饮食干预可显著降低GDM患者血糖和血脂水平,改善患者胰岛素抵抗情况,降低患者血清脂联素和内脂素水平,改善患者妊娠结局,提高患者生活质量。
Objective To investigate the effect of exercise combined diet intervention on insulin resistance, serum adiponectin and visfatin in patients with gestational diabetes mellitus (GDM). Methods From January 2015 to December 2016, 80 cases of GDM patients treated in Laizhou MCH hospital were randomly divided into observation group and control group, 40 cases in each group. The patients in observation group were treated with exercise combined diet intervention , The control group of patients with GDM only conventional guidance during pregnancy, the two groups of patients were measured before and after the intervention fasting blood glucose, 2 h postprandial blood glucose, insulin resistance index (HOMA-IR), serum adiponectin, visfatin, glycerol Triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels were compared. Pregnancy outcome was compared between the two groups. Results Before intervention, there was no significant difference in blood glucose, insulin resistance, serum adiponectin, visfatin, triglyceride, total cholesterol, LDL-C and HDL-C before intervention There was significant difference between the two groups (P <0.05). The number of adverse pregnancy outcomes in the observation group was less than that in the control group, and the difference was statistically significant (P <0.05). Conclusion Exercise combined with dietary intervention can significantly reduce blood glucose and blood lipid levels, improve insulin resistance in patients with GDM, reduce serum adiponectin and visfatin levels, improve pregnancy outcomes and improve quality of life of patients.