Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, USA.
Diabetes Care. 2011 Jul;34(7):1564-9. doi: 10.2337/dc11-0135.
Higher heme iron intake is associated with increased type 2 diabetes risk. However, no previous study has evaluated gestational diabetes mellitus (GDM) risk in relation to heme iron intake during pregnancy. We investigated associations of maternal preconceptional and early pregnancy heme and nonheme iron intake with subsequent GDM risk.
We conducted a prospective cohort study of 3,158 pregnant women. A food frequency questionnaire was used to assess maternal diet. Multivariable generalized linear regression models were used to derive estimates of relative risks (RRs) and 95% CIs.
Approximately 5.0% of the cohort developed GDM (n=158). Heme iron intake was positively and significantly associated with GDM risk (Ptrend=0.04). After adjusting for confounders, women reporting the highest heme iron intake levels (≥1.52 vs. <0.48 mg per day) experienced a 3.31-fold-increased GDM risk (95% CI 1.02-10.72). In fully adjusted models, we noted that a 1-mg per day increase in heme iron was associated with a 51% increased GDM risk (RR 1.51 [95% CI 0.99-2.36]). Nonheme iron was inversely, though not statistically significantly, associated with GDM risk, and the corresponding RRs were 1.00, 0.83, 0.62, and 0.61 across quartiles of nonheme iron intake (Ptrend=0.08).
High levels of dietary heme iron intake during the preconceptional and early pregnancy period may be associated with increased GDM risk. Associations of GDM risk with dietary nonheme iron intake are less clear. Confirmation of these findings by future studies is warranted.
较高的血红素铁摄入量与 2 型糖尿病风险增加有关。然而，以前没有研究评估怀孕期间血红素铁摄入与妊娠糖尿病（GDM）风险之间的关系。我们研究了母亲孕前和孕早期血红素和非血红素铁摄入与随后发生 GDM 风险的关系。
我们进行了一项前瞻性队列研究，共纳入 3158 名孕妇。使用食物频率问卷评估了母亲的饮食。使用多变量广义线性回归模型得出相对风险（RR）和 95%置信区间（CI）的估计值。
大约 5.0%的队列发生了 GDM（n=158）。血红素铁摄入量与 GDM 风险呈正相关且具有统计学意义（Ptrend=0.04）。在校正混杂因素后，报告血红素铁摄入量最高（≥1.52 与 <0.48mg/天）的女性发生 GDM 的风险增加了 3.31 倍（95%CI 1.02-10.72）。在完全校正模型中，我们发现血红素铁每天增加 1mg，GDM 风险增加 51%（RR 1.51[95%CI 0.99-2.36]）。非血红素铁与 GDM 风险呈负相关，但无统计学意义，非血红素铁摄入量四分位间距的相应 RR 分别为 1.00、0.83、0.62 和 0.61（Ptrend=0.08）。
在孕前和孕早期，饮食中血红素铁摄入量较高可能与 GDM 风险增加有关。饮食中非血红素铁摄入与 GDM 风险之间的关系不太明确。未来的研究需要进一步证实这些发现。
