妊娠期补充不同肌醇立体异构体对高危孕妇妊娠期糖尿病和胎儿结局的影响:一项随机对照试验。

PubMed ID
发表日期 2020年Mar月

原始出处 母婴医学杂志:欧洲围产期医学协会、亚洲和大洋洲围产期学会联合会、国际围产期产科医师学会的官方刊物
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
作者 Celentano  Claudio  Matarrelli  Barbara  Pavone  Giulia  Vitacolonna  Ester  Mattei  Peter A  Berghella  Vincenzo  Liberati  Marco 

文献标题 妊娠期补充不同肌醇立体异构体对高危孕妇妊娠期糖尿病和胎儿结局的影响:一项随机对照试验。
The influence of different inositol stereoisomers supplementation in pregnancy on maternal gestational diabetes mellitus and fetal outcomes in high-risk patients: a randomized controlled trial.

文献摘要

目的:探讨不同膳食肌醇立体异构体对胰岛素抵抗的影响及妊娠期糖尿病(GDM)高危人群的发生发展混乱。设计:初步的、前瞻性的、随机的,安慰剂对照临床试验试验。参与者:对在妊娠早期或中期空腹血糖升高的非肥胖单胎孕妇进行了全程研究怀孕。干预:补充肌醇、d-chiro-肌醇、联合肌醇和d-chiro-肌醇或安慰剂。主要结果测量:在75岁儿童上进行GDM检查妊娠24-28周口服葡萄糖耐量试验。次要结果指标是体重指数增加,需要母体胰岛素治疗,巨大儿,羊水过多,新生儿出生体重和低血糖。结果:单独接受肌醇治疗的妇女组口服葡萄糖耐量试验(OGTT)异常的发生率较低。对照组(C)中有9名女性,其中1名为肌醇(MI),5名为d-chiro-肌醇(DCI),3名为myo-inositol/d-chiro-inositol组(MI/DCI)需要胰岛素(p = .134)。暴露组的基础、1小时和2小时血糖控制明显低于对照组(p<<0.001、.011和.037)。MI、DCI和MI/DCI与主要结果相关的相对风险降低分别为0.083、0.559和0.621小组。结论本研究比较不同肌醇立体异构体在妊娠期预防GDM的作用。非劣效性分析显示肌醇组获益最大。我们的研究结果的相关性主要与GDM中有效方法的可能性有关。我们的研究证实了补充肌醇对有GDM风险的孕妇的疗效。


Objective: To identify the effects of different dietary inositol stereoisomers on insulin resistance and the development of gestational diabetes mellitus (GDM) in women at high risk for this disorder.Design: A preliminary, prospective, randomized, placebo controlled clinical trial.Participants: Nonobese singleton pregnant women with an elevated fasting glucose in the first or early second trimester were studied throughout pregnancy.Intervention: Supplementation with myo-inositol, d-chiro-inositol, combined myo- and d-chiro-inositol or placebo.Main outcome measure: Development of GDM on a 75 grams oral glucose tolerance test at 24-28 weeks' gestation. Secondary outcome measures were increase in BMI, need for maternal insulin therapy, macrosomia, polyhydramnios, neonatal birthweight and hypoglycemia.Results: The group of women allocated to receive myo-inositol alone had a lower incidence of abnormal oral glucose tolerance test (OGTT). Nine women in the control group (C), one of the myo-inositol (MI), five in d-chiro-inositol (DCI), three in the myo-inositol/D-chiro-inositol group (MI/DCI) required insulin (p = .134). Basal, 1-hour, and 2 hours glycemic controls were significantly lower in exposed groups (p < .001, .011, and .037, respectively). The relative risk reduction related to primary outcome was 0.083, 0.559, and 0.621 for MI, DCI, and MI/DCI groups.Conclusions: This study compared the different inositol stereoisomers in pregnancy to prevent GDM. Noninferiority analysis demonstrated the largest benefit in the myo-inositol group. The relevance of our findings is mainly related to the possibility of an effective approach in GDM. Our study confirmed the efficacy of inositol supplementation in pregnant women at risk for GDM.


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