Barbieiri Patrícia, Nunes Juliana C, Torres Alexandre G, Nishimura Renata Y, Zuccolotto Daniela C C, Crivellenti Lívia C, Franco Laércio J, Sartorelli Daniela S
Graduate Program in Community Health, Ribeirão Preto Medical School (FMRP), University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
Department of Food Technology, School of Nutrition, Federal University of Rio de Janeiro State (UNIRIO), Rio de Janeiro, RJ, Brazil.
Nutrition. 2016 Jun;32(6):656-61. doi: 10.1016/j.nut.2015.12.002. Epub 2015 Dec 18.
To investigate the relationship between gestational diabetes mellitus (GDM) and the usual intake of fatty acids and indices of dietary fat quality [the atherogenicity (AI) and thrombogenicity indices (TI), and the ratios of hypo-and hypercholesterolemic (hH), ∑n-3/∑n-6, and polyunsaturated/saturated fatty acids (P:S)], during mid-pregnancy.
799 adult pregnant women living in Ribeirão Preto, SP, Brazil were screened and accepted for this cross-sectional GDM study. The Multiple Source Method was used to estimate participants' usual diet, using two 24-hour dietary recalls during mid-pregnancy. Diagnosis of GDM was defined by the American Diabetes Association criteria of 2015. Logistic regression analysis were used to assess the association between GDM and dietary fat, adjusted for age, education, parity, gestational age at the time of the interview, pre-pregnancy and current BMI, prior GDM, family history of diabetes, smoking, physical activity, energy, fiber, and fatty acids.
The mean (standard deviation) age of the women was 28 (5) years, and 19% had GDM. After multiple adjustments, inverse associations between the highest tertile of ∑n-3 fatty acids intake [0.21 (0.08-0.56)], α-linolenic intake [0.15 (0.05-0.42)], and GDM were found. A positive association between GDM and the highest tertile of TI [2.66 (1.34-5.29)], and a negative association with the highest tertile of hH ratio [0.41 (0.22-0.77)], were observed. No association between GDM and other indices of dietary fat quality were found.
The quality of dietary fat during pregnancy is strongly associated with GDM. Randomized clinical trial are needed to confirm these findings.
探讨妊娠中期妊娠期糖尿病（GDM）与脂肪酸的日常摄入量及膳食脂肪质量指标[致动脉粥样硬化指数（AI）和血栓形成指数（TI），以及低胆固醇与高胆固醇（hH）比值、∑n-3/∑n-6比值和多不饱和脂肪酸与饱和脂肪酸比值（P:S）]之间的关系。
对居住在巴西圣保罗州里贝朗普雷图的799名成年孕妇进行筛查，并纳入这项横断面GDM研究。采用多源法，通过妊娠中期的两次24小时膳食回顾来估计参与者的日常饮食。GDM的诊断依据2015年美国糖尿病协会标准。采用逻辑回归分析评估GDM与膳食脂肪之间的关联，并对年龄、教育程度、产次、访谈时的孕周、孕前和当前体重指数、既往GDM史、糖尿病家族史、吸烟、体力活动、能量、纤维和脂肪酸进行校正。
这些女性的平均（标准差）年龄为28（5）岁，19%患有GDM。经过多次校正后，发现∑n-3脂肪酸摄入量最高三分位数[0.21（0.08-0.56）]、α-亚麻酸摄入量最高三分位数[0.15（0.05-0.42）]与GDM之间呈负相关。观察到GDM与TI最高三分位数[2.66（1.34-5.29）]呈正相关，与hH比值最高三分位数[0.41（0.22-0.77）]呈负相关。未发现GDM与其他膳食脂肪质量指标之间存在关联。
孕期膳食脂肪质量与GDM密切相关。需要进行随机临床试验来证实这些发现。
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