en تأثیر میواینوزیتول در پیشگیری از دیابت بارداری در بارداری‌های پرخطر: یک کارآزمایی بالینی تصادفی شده Perinatology Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">دیابت بارداری یک مشکل رو به افزایش در سراسر جهان است که در صورت عدم تشخیص و درمان به موقع می&shy;تواند منجر به عوارض مادری، جنینی و نوزادی شود. بنابراین توجه به عوامل مستعد&shy;کننده و پیشگیری از دیابت بارداری بسیار مهم است.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف از این مطالعه بررسی تأثیر میواینوزیتول بر پیشگیری از دیابت بارداری و سایر پیامدهای بارداری است.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش &shy;ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این کارآزمایی تصادفی‌سازی&shy;شده‌ی کنترل‌دار در بیمارستان زنان آرش و مجتمع بیمارستانی یاس بین نوامبر 2019 تا می 2020 انجام شد و شامل 150 زن بود که به 2 گروه (هر کدام 75 نفر) تقسیم شدند. زنان 4000 میلی&shy;گرم </span></span><span dir="LTR" style="font-size:10.0pt">MI</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">به اضافه 400 میلی&shy;گرم اسید&shy;فولیک روزانه در گروه میواینوزیتول و 400 میلی&shy;گرم اسید&shy;فولیک در گروه دارونما از هفته 14-11 بارداری به مدت 14 هفته دریافت کردند. شرکت&shy;کنندگان در هفته 28-24 تحت آزمایش تحمل گلوکز خوراکی 75 گرمی قرار گرفتند و تا زمان زایمان پیگیری شدند.</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">پس از تعدیل عوامل مداخله‌گر، درمان میواینوزیتول با کاهش قابل‌توجه دیابت بارداری همراه بود (020/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 91/0، 36/0، 58/0 </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">aRR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). با این حال، تفاوت معنی&shy;داری بین دو گروه در موارد دیگر پیامدهای بارداری و قند خون در هر مرحله از مقادیر </span></span><span dir="LTR" style="font-size:10.0pt">OGTT</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">وجود نداشت.</span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری:</span></span></b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> نتایج ما نشان داد که میواینوزیتول به&shy;طور قابل توجهی دیابت بارداری را کاهش می&shy;دهد. با توجه به ناکافی بودن شواهد، مطالعات بیشتر با حجم نمونه مناسب توصیه می&shy;شود.</span></span></div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Background:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> Gestational diabetes mellitus (GDM) is a rising problem which, if not diagnosed and treated in time, can lead to maternal, fetal, and neonatal complications. Therefore, it is very important to consider predisposing factors and prevention of GDM.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Objective:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> This study aims to investigate the effect of myo-inositol (MI) on the prevention of GDM and other pregnancy outcomes.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="text-autospace:none"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Materials and Methods:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> This randomized controlled trial was conducted at the Arash Women&rsquo;s hospital and Yas hospital Complex, Tehran, Iran between November 2019 and May 2020 and included 150 women, the study was divided into 2 groups (n = 75/each). Women received 4000 mg of MI plus 400 mg of folic acid daily in the MI group and 400 mg of folic acid in the placebo group from 11-14 gestational weeks for 14 wk. Participants underwent 75 gr oral glucose tolerance test at 24-28 wk and were followed up until delivery.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="background:white"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Results: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">After adjustment for confounding factors, MI treatment was associated with a significant reduction of GDM (aRR: 0.58, 0.36, 0.91, p = 0.020). However, no significant difference was observed between the 2 groups in cases of other pregnancy outcomes and glycemia at each step of oral glucose tolerance test values. </span></span></span></span></span></span><br> <b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times=""> Our results showed that MI significantly reduced GDM. </span></span></span><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">With insufficient evidences, more studies with an appropriate sample size are recommended.</span></span></span></div> دیابت بارداری, بارداری, میواینوزیتول, پیشگیری اولیه. Gestational diabetes mellitus, Pregnancy, Myo-inositol, Primary prevention. 323 332 http://ijrm.ir/browse.php?a_code=A-10-2213-2&slc_lang=en&sid=1 Ashraf Moini ashraf.moieni@gmail.com 0000-0002-5074-2286 No Obstetrics and Gynecology Department, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahboobeh Shirazi mahboobehshirazi4@gmail.com 0000-0001-9980-4815 No Obstetrics and Gynecology Department, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahdi Sepidarkish mahdi.sepidarkish@gmail.com 0000-0003-4732-6684 No Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Maryam Rabiei rabieimaryam1394@yahoo.com 0000-0002-3484-8873 No Obstetrics and Gynecology Department, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Afsaneh Tehranian afsanehtehranian@yahoo.com 0000-0001-9119-9593 No Obstetrics and Gynecology Department, Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Arshia Shizarpour a-shizarpour@student.tums.ac.ir 0000-0001-6133-1856 No Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran. Reihaneh Pirjani pirjani@razi.tums.ac.ir 0000-0002-4102-7475 Yes Obstetrics and Gynecology Department, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.