Diabetes Center, National University of Athens, Athens, Greece.
First Endocrine Section and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, Athens, Greece.
Eur J Clin Nutr. 2014 Jan;68(1):8-13. doi: 10.1038/ejcn.2013.177. Epub 2013 Oct 2.
BACKGROUND/OBJECTIVES: Some studies document relationships of the incidence of gestational diabetes mellitus (GDM) with individual components of the diet, but studies exploring relationships with patterns of eating are lacking. This observational study aimed to explore a possible relationship between the incidence of GDM and the Mediterranean diet (MedDiet) pattern of eating.
SUBJECTS/METHODS: In 10 Mediterranean countries, 1076 consecutive pregnant women underwent a 75-g OGTT at the 24th-32nd week of gestation, interpreted both by the ADA_2010 and the International Association of the Diabetes and Pregnancy Study Groups (IADPSG)_2012 criteria. The dietary habits were assessed by a previously validated questionnaire and a Mediterranean Diet Index (MDI) was computed, reflecting the degree of adherence to the MedDiet pattern of eating: a higher MDI denoting better adherence.
After adjustment for age, BMI, diabetes in the family, weight gain and energy intake, subjects with GDM, by either criterion, had lower MDI (ADA_2010, 5.8 vs 6.3, P=0.028; IADPSG_2012, 5.9 vs 6.4, P<0.001). Moreover, the incidence of GDM was lower in subjects with better adherence to the MedDiet (higher tertile of MDI distribution), 8.0% vs 12.3%, OR=0.618, P=0.030 by ADA_2010 and 24.3% vs 32.8%, OR=0.655, P=0.004 by IADPSG_2012 criteria. In subjects without GDM, MDI was negatively correlated with both fasting plasma glucose and AUC glucose, P<0.001 for both.
Adherence to a MedDiet pattern of eating is associated with lower incidence of GDM and better degree of glucose tolerance, even in women without GDM. The possibility to use MedDiet for the prevention of GDM deserves further testing with intervention studies.
背景/目的：一些研究记录了妊娠期糖尿病（GDM）的发生率与饮食的各个成分之间的关系，但缺乏探索饮食模式与这些关系的研究。本观察性研究旨在探索 GDM 发生率与地中海饮食（MedDiet）模式之间的可能关系。
受试者/方法：在 10 个地中海国家，1076 名连续妊娠的孕妇在妊娠 24-32 周时进行了 75g OGTT，采用 ADA_2010 和国际糖尿病与妊娠研究组（IADPSG）_2012 标准进行解读。通过先前验证的问卷评估饮食习惯，并计算地中海饮食指数（MDI），反映对 MedDiet 模式的依从程度：更高的 MDI 表示更好的依从性。
在校正年龄、BMI、家族糖尿病、体重增加和能量摄入后，根据任一标准，GDM 患者的 MDI 均较低（ADA_2010，5.8 与 6.3，P=0.028；IADPSG_2012，5.9 与 6.4，P<0.001）。此外，在对 MedDiet 依从性更好（MDI 分布的较高三分位）的受试者中，GDM 的发生率较低，分别为 8.0%与 12.3%，比值比（OR）=0.618，P=0.030 （ADA_2010）和 24.3%与 32.8%，OR=0.655，P=0.004（IADPSG_2012）。在没有 GDM 的受试者中，MDI 与空腹血糖和 AUC 葡萄糖均呈负相关，均 P<0.001。
遵循 MedDiet 模式与 GDM 发生率较低和更好的葡萄糖耐量相关，即使在没有 GDM 的女性中也是如此。使用 MedDiet 预防 GDM 的可能性值得进一步通过干预研究进行检验。
