Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA.
Diabetes Care. 2013 Jul;36(7):2001-8. doi: 10.2337/dc12-2018. Epub 2013 Feb 1.
Dietary protein is an important modulator of glucose metabolism. However, studies regarding the association between dietary protein intake and gestational diabetes mellitus (GDM) risk are sparse. This study was to examine the association.
Our study included 21,457 singleton pregnancies reported among 15,294 participants of the Nurses' Health Study II cohort between 1991 and 2001. Included pregnancies were free of chronic diseases before pregnancy or previous GDM. Generalized estimating equations were used to estimate the relative risks (RRs) and 95% CIs.
After adjustment for age, parity, nondietary and dietary factors, and BMI, multivariable RRs (95% CIs) comparing the highest with lowest quintiles were 1.49 (1.03-2.17) for animal protein intake and 0.69 (0.50-0.97) for vegetable protein intake. The substitution of 5% energy from vegetable protein for animal protein was associated with a 51% lower risk of GDM (RR [95% CI], 0.49 [0.29-0.84]). For major dietary protein sources, multivariable RRs (95% CIs) comparing the highest with the lowest quintiles were 2.05 (1.55-2.73) for total red meat and 0.73 (0.56-0.95) for nuts, respectively. The substitution of red meat with poultry, fish, nuts, or legumes showed a significantly lower risk of GDM.
Higher intake of animal protein, in particular red meat, was significantly associated with a greater risk of GDM. By contrast, higher intake of vegetable protein, specifically nuts, was associated with a significantly lower risk. Substitution of vegetable protein for animal protein, as well as substitution of some healthy protein sources for red meat, was associated with a lower risk of GDM.
膳食蛋白质是调节葡萄糖代谢的重要因素。然而，关于膳食蛋白质摄入量与妊娠期糖尿病（GDM）风险之间的关联研究较少。本研究旨在探讨这种关联。
我们的研究纳入了 1991 年至 2001 年间参加护士健康研究 II 队列的 15294 名参与者报告的 21457 例单胎妊娠。纳入的妊娠在妊娠前或既往无慢性疾病或 GDM。使用广义估计方程来估计相对风险（RR）和 95%置信区间（CI）。
在调整年龄、产次、非饮食和饮食因素以及 BMI 后，与最低五分位数相比，最高五分位数的多变量 RR（95%CI）分别为动物蛋白摄入量 1.49（1.03-2.17）和植物蛋白摄入量 0.69（0.50-0.97）。用植物蛋白替代 5%的能量与 GDM 风险降低 51%相关（RR [95%CI]，0.49 [0.29-0.84]）。对于主要的膳食蛋白质来源，与最低五分位数相比，最高五分位数的多变量 RR（95%CI）分别为总红肉 2.05（1.55-2.73）和坚果 0.73（0.56-0.95）。用禽肉、鱼、坚果或豆类替代红肉与 GDM 风险显著降低相关。
较高的动物蛋白摄入，特别是红肉，与 GDM 风险显著增加相关。相比之下，较高的植物蛋白摄入，特别是坚果，与较低的 GDM 风险显著相关。用植物蛋白替代动物蛋白，以及用一些健康的蛋白质来源替代红肉，与 GDM 风险降低相关。
