Abstract：Objective To explore the characteristics of the maternal body composition in the second trimester in patients with gestational diabetes mellitus (GDM). Methods A nested case-control study was conducted in pregnant women who participated in a multicenter cohort research from May 20, 2012 to December 31, 2013. 142 pregnant women who were diagnosed with GDM by 75g oral glucose tolerance test (OGTT) at 24-28 weeks of gestation (WG) were selected as the GDM group, meanwhile, 142 pregnant women without GDM in the research cohort served as the controls based on the match of pregnant age and pre-pregnancy body weight and body height. Multi-frequency bioelectrical impedance analysis was used to determine body composition in the subjects at 22-24 weeds of WG. The body weight (BW), body mass index (BMI), free fat mass (FFM), muscular mass (MM), fat mass (FM), fat mass percentage (FMP), total body water (TBW), extracellular water (ECW) and intracellular water (ICW) were analyzed and compared between the two groups. Results The BW, BMI, FM, FMP, TBW and ECW in the second trimester in the GDM group were all significantly higher than those of the control group (P<0.05), but no statistically significant difference was found in the FFM, MM and ICW between the two groups (P>0.05). Conclusions The body fat reserves and ECW of the GDM women in the second trimester are both significantly higher than those of the normal pregnant women, but their muscle reserves are similar to those of the normal pregnant women .
[1] 中华医学会妇产科学会产科学组, 中华医学会围产医学分会妊娠合并糖尿病协作组[J]. 妊娠合并糖尿病诊治指南(2014). 中华妇产科杂志, 2014,49(8):561-569. [2] Liao SY, Mei J, Song W, et al. The impact of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) fasting glucose diagnostic criterion on the prevalence and outcomes of gestational diabetes mellitus in Han Chinese women[J]. Diabetic Med,2014,31(3):341-351. [3] 杨慧霞. 妊娠合并症[M]. 北京: 人民卫生出版社, 2006:82-89. [4] Liu Z, Ao D, Yang H, et al. Gestational weight gain and risk of gestational diabetes mellitus among Chinese women[J]. Chin Med J(Engl), 2014,127(7):1255-1260. [5] Zhang C, Ning Y. Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence[J]. Am J Clin Nutr, 2011,94(6 Suppl):1975S-1979S. [6] Sommer C, Morkrid K, Jenum AK, et aI. Weight gain, total fat gain and regional fat gain during pregnancy and the association with gestational diabetes: a population-based cohort study[J]. Int J Obes (Lond), 2014,38(1):76-81. [7] 孙力, 王德峰. 妊娠期糖尿病危险因素对母婴结局的影响[J]. 实用预防医学, 2016,23(3):330-331. [8] Xu Q, Gao ZY, Li LM, et al. The association of maternal body composition and dietary intake with the risk of gestational diabetes mellitus during the second trimester in a cohort of Chinese pregnant women[J]. Biomed Environ Sci, 2016,29(1):1-11. [9] 林宁, 潘搏, 王洁,等. 生物电阻抗技术临床应用现状及探讨[J]. 肠外与肠内营养,2010,17(2):122-124. [10] 肖贵遐, 刘国庆, 吴瑛,等. 用生物电阻抗法评价人体成份[J]. 中国医学物理学杂志,1998,15(1):57-58,61. [11] Mccarthy EA, Strauss BJ, Walker SP, et al. Determination of maternal body composition in pregnancy and its relevance to perinatal outcomes[J]. Obstet Gynecol Sur, 2004,59(10):731-742. [12] 李力, 张谦. 85例妊娠期糖尿病和正常妊娠妇女的人体成分的比较分析[C]. 第十四届全国临床营养学术会议,2014. [13] 苗苗, 张悦, 戴永梅. 5353例妊娠期妇女体重及体成份的测定与分析[J]. 现代预防医学, 2014,41(6):1004-1009. [14] 林锦芬, 吴元赭, 王新颖,等. 母体生物电阻抗分析与新生儿出生体质量关系的研究[J]. 肠外与肠内营养, 2008,15(3):161-163. [15] 林锦芬, 吴元赭, 王新颖. 孕期母体营养与胎儿出生体质量[J]. 肠外与肠内营养, 2008,15(1):52-55. [16] 林锦芬, 吴元赭, 王新颖, 等. 孕晚期母亲体成分和血脂水平与新生儿出生体重关系的研究[J]. 中国优生与遗传杂志,2008,16(1):59-61. [17] Fattah C, Farah N, Barry SC,et al. Maternal weight and body composition in the first trimester of pregnancy[J]. Acta Obstet GynecolScand, 2010,89(7):952-955. [18] Tomedi LE, Simhan HN, Chang CC, et al. Gestational weight gain, early pregnancy maternal adiposity distribution, and maternal hyperglycemia[J]. Matern Child Health J, 2014,18(5):1265-1270. [19] Moreno Martinez S, Tufino Olivares E, Chavez Loya V, et al. Body composition in women with gestational diabetes mellitus[J].Ginecol Obstet Mex,2009,77(6):270-276. [20] 苗苗, 张悦, 戴永梅. 妊娠期糖尿病患者血清微量元素及人体体成分分析[J]. 中国糖尿病杂志, 2014,22(5):389-391. [21] 叶冬青. 巢式病例对照研究的设计及分析[J]. 疾病控制杂志,2001,5(1):65-68.
2017, Vol. 24 
