Favourable effects of the Dietary Approaches to Stop Hypertension diet on glucose tolerance and lipid profiles in gestational diabetes: a randomised clinical trial (Publication with Expression of Concern. See vol. 127, pg. 151, 2022)
Favourable effects of the Dietary Approaches to Stop Hypertension diet on glucose tolerance and lipid profiles in gestational diabetes: a randomised clinical trial (Publication with Expression of Concern. See vol. 127, pg. 151, 2022)
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DOI：
10.1017/s0007114512004242
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发表时间：
2013-06-14
影响因子：
3.6
通讯作者：
Esmaillzadeh, Ahmad
中科院分区：
文献类型：
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作者：
Asemi, Zatollah;Tabassi, Zohreh;Esmaillzadeh, Ahmad
虽然妊娠期糖尿病（GDM）与母亲和新生儿发病率的风险增加，有没有共识，以最佳的营养管理方法，在这些患者。本研究旨在评估DASH饮食计划对GDM孕妇糖耐量和血脂的影响。本随机对照临床试验在妊娠24-28周诊断为GDM的34名妇女中进行。受试者被随机分配到对照饮食（n 17）或DASH饮食模式（n 17）中，持续4周。对照饮食设计为含有45-55%的碳水化合物，15-20%的蛋白质和25-30%的总脂肪。DASH饮食的常量营养素组成与对照饮食相似;然而，DASH饮食富含水果、蔬菜、全谷物和低脂乳制品，饱和脂肪、胆固醇和精制谷物含量较低，总钠含量为2400 mg/d。在基线和干预4周后采集空腹血液样本，以测量空腹血糖、糖化血红蛋白（HbA 1c）和血脂。受试者接受3 h口服葡萄糖耐量试验，并在60、120和180 min采集血样以测量血浆葡萄糖水平。与对照饮食相比，坚持DASH饮食模式导致葡萄糖耐量改善，使得血糖水平在60葡萄糖负荷后120 min（-2.3 v. 0.2 mmol/l，P组= 0.001）和180 min（-1.7 v. 0.22 mmol/l，P组= 0.002）。与对照组相比，在DASH组中也观察到HbA 1c水平降低（-0.2 v. 0.05%，P组= 0.001）。血清总量的平均变化（-0.42 v. 0.31 mmol/l，P组= 0.01）和LDL-胆固醇（-0.47 v. 0.22 mmol/l，P组= 0.005），TAG（-0.17 v. 0.34 mmol/l，P组= 0.01）和总：HDL-胆固醇比（-0.6（SD 0.9）v. 0.3（SD 0.8），P组= 0.008）在两种饮食之间存在显著差异。此外，DASH饮食的消耗对收缩压有有利影响（-2.6 v. 1.7 mmHg，P组= 0.001）。与对照饮食相比，DASH饮食组空腹血糖的平均变化（-0.29 v. 0.15 mmol/l，P组= 0.09）不显著。总之，与对照饮食相比，GDM孕妇食用DASH饮食模式4周对葡萄糖耐量和脂质谱产生有益影响。
Although gestational diabetes mellitus (GDM) is associated with an increased risk of maternal and neonatal morbidity, there is no consensus as to the optimal approach of nutritional management in these patients. The present study was designed to assess the effect of the Dietary Approaches to Stop Hypertension (DASH) eating plan on glucose tolerance and lipid profiles of pregnant women with GDM. The present randomised controlled clinical trial was performed among thirty-four women diagnosed with GDM at 24-28 weeks of gestation. Subjects were randomly assigned to consume either the control diet (n 17) or the DASH eating pattern (n 17) for 4 weeks. The control diet was designed to contain 45-55% carbohydrates, 15-20% protein and 25-30% total fat. The macronutrient composition of the DASH diet was similar to the control diet; however, the DASH diet was rich in fruits, vegetables, whole grains and low-fat dairy products, and contained lower amounts of saturated fats, cholesterol and refined grains with a total of 2400 mg Na/d. Fasting blood samples were taken at baseline and after 4 weeks of intervention to measure fasting plasma glucose, glycated Hb (HbA1c) and lipid profiles. Participants underwent a 3 h oral glucose tolerance tests and blood samples were collected at 60, 120 and 180 min to measure plasma glucose levels. Adherence to the DASH eating pattern, compared with the control diet, resulted in improved glucose tolerance such that plasma glucose levels reduced at 60 (-1.86 v. -0.45 mmol/l, P-group = .0.02), 120 (-2.3 v. 0.2 mmol/l, P-group = 0.001) and 180 min (-1.7 v. 0.22 mmol/l, P-group = 0.002) after the glucose load. Decreased HbA1c levels (-0.2 v. 0.05%, P-group = 0.001) was also seen in the DASH group compared with the control group. Mean changes for serum total (-0.42 v. 0.31 mmol/l, P-group = 0.01) and LDL-cholesterol (-0.47 v. 0.22 mmol/l, Pgroup = 0.005), TAG (-0.17 v. 0.34 mmol/l, P-group = 0.01) and total: HDL-cholesterol ratio (-0.6 (SD 0.9) v. 0.3 (SD 0.8), P-group = 0.008) were significantly different between the two diets. Additionally, consumption of the DASH diet favourably influenced systolic blood pressure (-2.6 v. 1.7 mmHg, P-group = 0.001). Mean changes of fasting plasma glucose (-0.29 v. 0.15 mmol/l, P-group = 0.09) were non-significant comparing the DASH diet with the control diet. In conclusion, consumption of the DASH eating pattern for 4 weeks among pregnant women with GDM resulted in beneficial effects on glucose tolerance and lipid profiles compared with the control diet.