| 摘要: | 使用衛生福利部國民健康署委託研究計畫懷孕婦女營養狀況追蹤調查計畫(105-108年)資料，評估懷孕婦女的飲食狀況與罹患妊娠糖尿病的風險關係。妊娠糖尿病罹病率有越來越高的趨勢，近年的研究發現懷孕期婦女的飲食型態和妊娠糖尿病的罹患率有相關性，但亞洲在此方面的研究較少。資料來源抽取臺灣北、中、南、東11家醫療院所，包含臺北醫學大學附設醫院、台北慈濟醫院、台北國泰綜合醫院、振興醫療財團法人振興醫院、衛生福利部臺中醫院、高雄長庚紀念醫院、衛生福利部台東醫院、花蓮慈濟醫院、衛生福利部彰化醫院、衛生福利部嘉義醫院、臺灣基督教門諾會醫療財團法人門諾醫院，招募年齡介於15歲至49歲懷孕婦女共1502名，扣除小於20歲的婦女，最後納入有1495人。透過問卷訪視、飲食頻率問卷以主成分因子分析出飲食型態與罹患妊娠糖尿病的關係。
結果共有44名(3%)罹患妊娠糖尿病，且有妊娠糖尿病婦女的BMI (mean=24.8 kg/m2, SD=4.3 kg/m2)大於無妊娠糖尿病婦女的BMI (mean=22.6 kg/m2, SD=4.0 kg/m2)。將BMI分成三分位數，以邏輯斯迴歸檢定分析BMI與罹患妊娠糖尿病風險之關係，結果顯示在BMI越高的組別其罹患妊娠糖尿病也越高，BMI值在三分位最高組別，其罹患妊娠糖尿病的勝算比會增加為三分位最低組別的3.6倍。
以因素分析將飲食分為四種型態海藻全榖根莖飲食型態、肉類加工類飲食型態、魚類水果飲食型態、米類海水魚飲食型態，以邏輯斯回歸分析飲食型態與罹患妊娠糖尿病之關係，結果顯示婦女攝取米類海水魚飲食型態其妊娠糖尿病的罹患率較高。
建議懷孕婦女孕前維持正常體位、孕期少吃米類海水魚飲食型態減少罹患妊娠糖尿病風險。
The incidence of gestational diabetes is on the rise. Recent studies have found that dietary patterns were associated with the incidence of gestational diabetes, but there are few studies in Asia in this regard. The data were obtained from the Nutritional Survey of Pregnant Women in Taiwan (NPWT). The survey included a cross-sectional study from June 2017 to February 2019, which was conducted in pregnant women aged ≥ 15 years and living in Taiwan. There were 1,502 pregnant women, and a total of 1,495 pregnant women were included after excluding women aged < 20 years. The study population was selected based on a multiple-stage sampling plan.The data source was selected from 11 medical institutions in northern, central, southern and eastern Taiwan, including Taipei Medical University Affiliated Hospital, Taipei Tzu Chi Hospital, Taipei Cathay General Hospital, Zhen Xing Medical Foundation Corporation Zhen Xing Hospital, Ministry of Health and Welfare Taichung Hospital, Kaohsiung Chang Gung Memorial Hospitals, Taitung Hospital of the Ministry of Health and Welfare, Hualien Tzu Chi Hospital, Changhua Hospital of the Ministry of Health and Welfare, Chiayi Hospital of the Ministry of Health and Welfare, and Mennonite Hospital of Taiwan Christian Mennonite Medical Foundation. The association between dietary patterns and gestational diabetes mellitus was analyzed by principal component analysis through visit questionnaire and eating frequency questionnaires.
The results showed that BMI was greater in the women with gestational diabetes than that in the women without gestational diabetes. The BMI values were divided into tertiles. After analyzed by logistic regression test, the results showed that the women in the higher BMI group were associated with an increased risk of gestational diabetes. The odds ratio of gestational diabetes was increased by 3.6 times in pregnant women in the highest terile group of BMI compared to those in the lowest tertile group.
Four dietary patterns were derived by factor analysis: seaweed/whole grains/root crops, meat/processed food, freshwater fish/fruits, and rice/sea fish dietary patterns. The relationship between dietary patterns and gestational diabetes was analyzed by logistic regression. The results showed that the incidence of gestational diabetes was higher in pregnant women who consumed rice/sea fish dietary pattern.
It is recommended that pregnant women maintain normal BMI before pregnancy and eat less rice and sea fish during pregnancy to reduce the risk of gestational diabetes. |
