Unitat de Nutrició i Salut Pública, Research Group in Nutrition and Mental Health (NUTRISAM), Reus, Tarragona, Spain.
Departamento de Nutrición y Dietética,Facultad de Ciencias de la Salud, Universidad de Atacama, Copiapó, III Región, Chile.
Matern Child Nutr. 2017 Oct;13(4). doi: 10.1111/mcn.12400. Epub 2016 Dec 14.
The aim of this systematic review and meta-analysis of observational studies was to assess the relationship between elevated iron status, measured as hemoglobin and ferritin levels, and the risk of gestational diabetes mellitus (GDM). The present study was recorded in PROSPERO (2013:CRD42013005717). The selected studies were identified through a systematic review of scientific literature published in The Cochrane Library and PubMed/MEDLINE databases from their inception until March 10, 2016, in addition to citation tracking and hand-searches. The search strategy of original articles combined several terms for hemoglobin, ferritin, pregnancy, and GDM. OR and 95% CI of the selected studies were used to identify associations between hemoglobin and/or ferritin levels with the risk of GDM. Summary estimates were calculated by combining inverse-variance using fixed-effects model. 2468 abstracts were initially found during the search. Of these, 11 with hemoglobin and/or ferritin data were selected for the meta-analyses. We observed that high hemoglobin (OR = 1.52; 95% CI: 1.23-1.88), as well as ferritin (OR = 2.09; 95% CI: 1.48-2.96) levels were linked to an increased risk of GDM. Low heterogeneity was observed in hemoglobin (I = 33.3%, P = 0.151) and ferritin (I = 0.7%, P = 0.418) meta-analyses, respectively. Publication bias was not appreciated. High hemoglobin or ferritin levels increase the risk of GDM by more than 50% and more than double, respectively, in the first and third trimester. Therefore, determining of hemoglobin or ferritin concentration in early pregnancy might be a useful tool for recognizing pregnant women at risk of GDM.
本系统评价和观察性研究的荟萃分析旨在评估铁状态升高（以血红蛋白和铁蛋白水平衡量）与妊娠糖尿病（GDM）风险之间的关系。本研究在 PROSPERO（2013：CRD42013005717）中进行了记录。通过对 Cochrane 图书馆和 PubMed/MEDLINE 数据库中自成立以来至 2016 年 3 月 10 日发表的科学文献进行系统回顾，以及引文追踪和手工检索，确定了入选研究。原始文章的检索策略结合了血红蛋白、铁蛋白、妊娠和 GDM 的多个术语。采用 OR 和 95%CI 来识别血红蛋白和/或铁蛋白水平与 GDM 风险之间的关系。通过固定效应模型的逆方差合并计算汇总估计值。在搜索过程中最初发现了 2468 篇摘要。其中，有 11 篇有血红蛋白和/或铁蛋白数据，用于荟萃分析。我们发现，高血红蛋白（OR=1.52；95%CI：1.23-1.88）和铁蛋白（OR=2.09；95%CI：1.48-2.96）水平与 GDM 风险增加相关。血红蛋白（I²=33.3%，P=0.151）和铁蛋白（I²=0.7%，P=0.418）荟萃分析中观察到低异质性。未发现发表偏倚。在第一个和第三个三个月，高血红蛋白或铁蛋白水平分别使 GDM 的风险增加超过 50%和超过两倍。因此，在孕早期确定血红蛋白或铁蛋白浓度可能是识别 GDM 高危孕妇的有用工具。
