Abstract：Objective To examine the association between dietary patterns during pregnancy and gestational diabetes mellitus (GDM), so as to provide the evidence for guiding the establishment of healthy and balanced dietary patterns and reducing the prevalence of GDM. Methods Pregnant women who underwent oral glucose tolerance tests in Hangzhou Obstetrics and Gynecological Hospital from 2020 to 2021 were enrolled, and their demographic information were collected using questionnaires. Pregnant women's diets during the past three months were collected using Food Frequency Questionnaires (FFQs), and dietary patterns were extracted using principal component analysis. In addition, the association between dietary patterns and risk of GDM was examined using a multivariable logistic regression model. Results A total of 1 689 pregnant women were included, with a median age of 28.53 (interquartile range, 2.47) years and a median gestational age of 26.00 (interquartile range, 2.00) weeks. Five dietary patterns were identified according to pregnant women's types of diets, including meat-based diets, dessert-fruit-refined grain diets, plant-based diets, eggs-milk-nut diets and whole-grain diets, with a cumulative contribution rate of 58.76%. The prevalence of GDM was 24.57% (415 cases) among the study subjects. Multivariable logistic regression analysis showed that pregnant women with scores in the highest quartile (Q4) of the meat-based diets had an increased risk of GDM (OR=1.372, 95%CI: 1.043-2.055) relative to those with scores in the lowest quartile (Q1), and pregnant women with Q4 scores of the dessert-fruit-refined grain diets had an increased risk of GDM (OR=1.743, 95%CI: 1.397-2.432) relative to those with Q1 scores, while pregnant women with Q4 scores of the plant-based diets had a reduced risk of GDM (OR=0.382, 95%CI: 0.346-0.613) relative to those with Q1 scores. Conclusion A plant-based dietary pattern may reduce the risk of GDM, while meat-based and dessert-fruit-refined grain dietary patterns may increase the risk of GDM.
史美琦, 郑钜圣, 汪旭虹, 殷玉华, 胡文胜. 孕期膳食模式与妊娠糖尿病的关联分析[J]. 预防医学, 2023, 35(11): 921-925.
SHI Meiqi, ZHENG Jusheng, WANG Xuhong, YIN Yuhua, HU Wensheng. Association between dietary patterns during pregnancy and gestational diabetes mellitus. Preventive Medicine, 2023, 35(11): 921-925.
[1] ZHU W W,YANG H X,WEI Y M,et al.Evaluation of the value of fasting plasma glucose in the first prenatal visit to diagnose gestational diabetes mellitus in China[J]. Diabetes Care,2013,36:586-590. [2] 张芝银,李秀央,郑国英,等.不良妊娠结局的影响因素分析[J]. 预防医学,2020,32(1):94-97. [3] BELLAMY L,CASAS J P,HINGORANI A D,et al.Type 2 diabetes mellitus after gestational diabetes:a systematic review and meta-analysis[J]. Lancet,2009,373:1773-1779. [4] 蒋剑波,林玲萍,杜丽云,等.杭州市中年人群三种膳食模式与代谢综合征的关系研究[J]. 预防医学,2018,30(12):1222-1225. [5] ZHENG P F,SHU L,ZHANG X Y,et al.Association between dietary patterns and the risk of hypertension among Chinese:across-sectional study[J]. Nutrients,2016,8(4):239-248. [6] HONG X,XU F,WANG Z Y,et al.Dietary patternsand the incidence of hyperglyacemia in China[J]. Public Health Nutr,2016,19(1):131-141. [7] XIA Y,XIANG Q,GU Y Q,et al.A dietary patternrich in animal organ,seafood and processed meat products is associated with newly diagnosed hyperuricaemia in Chinese adults:a propensity score-matched case-control study[J]. Brit J Nutr,2018,119(10):1177-1184. [8] SHU L,ZHENG P F,ZHANG X Y,et al.Association between dietary patterns and the indicators of obesity among Chinese: across-sectional study[J]. Nutrients,2015,7(9):7995-8009. [9] 李建明. 睡眠状况自评量表(SRSS)简介[J]. 中国健康心理学杂志,2012,20(12):1851. [10] 陈文莹,胡继军,涂星,等.SCL-90评定情况与胃镜检查耐受性的关系[J]. 临床和实验医学杂志,2020,19(18):1959-1962. [11] 中国肥胖问题工作组. 中国成人超重和肥胖症预防与控制指南(节录)[J]. 营养学报,2014,26(1):1-2. [12] 谢幸,孔北华,段涛.妇产科学(第9版)[M]. 北京:人民卫生出版社,2008. [13] JIANG R,MA J,ASCHERIO A,et al.Dietary iron intake and blood donations in relation to risk of type 2 diabetes in men:a prospective cohort study[J]. Am J Clin Nutr,2004,79:70-75. [14] HU Z G,TAN R S,JIN D,et al.A low glycemic index staple diet re-duces postprandial glucose values in Asian women with gestational diabetes mellitus[J]. J Invest Med,2014,62(8):975-979. [15] BAO J,ATKINSON F,PETOCZ P,et al.Prediction of postprandial glycemia and insulinemia in lean,young,healthy adults:glycemic load compared with carbohydrate content alone[J]. Am J Clin Nutr,2011,93(5):984-996. [16] HODGE A M,ENGLISH D R,O'DEA K,et al. Glycemic index and dietary fiber and the risk of type 2 diabetes[J]. Diabetes Care,2004,27(11):2701-2706. [17] Inter Act Consortium,BENDINELLI B,PALLI D,et al.Association between dietary meat consumption and incident type 2 diabetes:the EPIC-InterAct study[J]. Diabetologia,2013,56:47-59. [18] MOHAN V,RANDHIKA G,SATHYA R M,et al.Dietary carbohydrates,glycaemic load,food groups and newly detected type 2 diabetes a-mong urban Asian Indian population in Chennai,India(Chennai Urban Rural Epidemiology Study 59)[J]. Br J Nutr,2009,102(10):1498-1506. [19] KONG A P,CHOI K C,CHAN R S,et al. A randomized controlled trial to investigate the impact of a low glycemic index (GI) diet on body mass index in obese adolescents[J/OL]. BMC Public Health,2014,14(1)[2023-10-17]. https://doi.org/10.1186/1471-2458-14-180. [20] CALDERON GUZMAN D,JUAREZ OLGUIN H,VELOZ CPRONA Q,et al.Consumption of cooked common beans or saponins could reduce the risk of diabetic complications[J]. Diabetes Metab Syndr Obes,2020,10(13):3481-3486.
