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软饮料消费与 SUN 项目中的妊娠糖尿病风险。

Soft drink consumption and gestational diabetes risk in the SUN project.

机构信息

Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.

Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Navarra's Health Research Institute (IDISNA), Pamplona, Spain; Institute for Culture and Society (ICS), University of Navarra, Spain.

出版信息

Clin Nutr. 2018 Apr;37(2):638-645. doi: 10.1016/j.clnu.2017.02.005. Epub 2017 Feb 20.

Abstract

BACKGROUND & AIMS: Gestational diabetes mellitus (GDM) prevalence is increasing worldwide. To the best of our knowledge the specific evaluation of soft drink consumption as a risk factor for developing GDM has only been conducted in the Nurses' Health Study II.

OBJECTIVE

To investigate the incidence of GDM according to soft drink consumption in the SUN project.

DESIGN

The "Seguimiento Universidad de Navarra" (SUN) project is a prospective and dynamic cohort which included data of 3396 women who notified at least one pregnancy between December 1999 and March 2012. A validated 136-item semi-quantitative food frequency questionnaire was used to assess soft drink consumption. Four categories of sugar-sweetened soft drink (SSSD) and diet soft drink (DSD) consumption (servings) were established: rarely or never (<1/month), low (1-3/month), intermediate (>3/month and ≤1/week) and high (≥2/week). Potential confounders were adjusted through non-conditional logistic regression models.

RESULTS

During the follow-up, we identified 172 incident cases of GDM. After adjusting for age, baseline body mass index, family history of diabetes, smoking, total energy intake, physical activity, parity, fast-food consumption, adherence to Mediterranean dietary pattern, alcohol intake, multiple pregnancy, cardiovascular disease/hypertension at baseline, fiber intake, following special diet and snacking, SSSD consumption was significantly associated with an increased risk of incident GDM, with multivariable adjusted odds ratios (OR) of 2.03 (95% confidence interval [CI]: 1.25-3.31) and 1.67 (95% CI: 1.01-2.77) for the highest and intermediate categories, respectively, versus the lowest category (p for linear trend: 0.006). Conversely, DSD consumption was not associated with GDM incidence (adjusted OR: 0.82; 95% CI: 0.52-1.31) for the highest versus the lowest category (p for linear trend: 0.258). Additional sensitivity analyses did not change the results.

CONCLUSION

Higher consumption of SSSDs before pregnancy was an independent risk factor for GDM, however, no association was observed between DSD consumption and GDM risk.

摘要

背景与目的

妊娠糖尿病(GDM)的患病率在全球范围内呈上升趋势。据我们所知,只有在护士健康研究 II 中专门评估了软饮料消费作为发生 GDM 的危险因素。

目的

在 SUN 项目中调查软饮料消费与 GDM 发病的关系。

设计

“纳瓦拉大学随访研究”(SUN)项目是一项前瞻性动态队列研究,其中包括 1999 年 12 月至 2012 年 3 月期间至少报告过一次妊娠的 3396 名女性的数据。使用经过验证的 136 项半定量食物频率问卷评估软饮料的消费情况。建立了四个含糖软饮料(SSSD)和无糖软饮料(DSD)消费(份)类别:很少或从不(<1/月)、低(1-3/月)、中(>3/月和≤1/周)和高(≥2/周)。通过非条件逻辑回归模型调整潜在混杂因素。

结果

在随访期间,我们发现了 172 例 GDM 新发病例。调整年龄、基线体重指数、糖尿病家族史、吸烟、总能量摄入、体力活动、产次、快餐消费、遵循地中海饮食模式、酒精摄入、多胎妊娠、基线时心血管疾病/高血压、纤维摄入、特殊饮食和零食后,SSSD 消费与 GDM 发病风险增加显著相关,多变量调整后的比值比(OR)分别为最高和中间类别(OR:2.03;95%置信区间[CI]:1.25-3.31)和 1.67(95% CI:1.01-2.77),与最低类别相比(线性趋势 p 值:0.006)。相反,DSD 消费与 GDM 发病率无相关性(最高与最低类别调整 OR:0.82;95% CI:0.52-1.31)(线性趋势 p 值:0.258)。进一步的敏感性分析并未改变结果。

结论

妊娠前较高的 SSSD 摄入量是 GDM 的独立危险因素,但 DSD 消费与 GDM 风险之间无关联。

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