Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan.
Department of Nutrition, Faculty of Health Care Science, Chiba Prefectural University of Health Sciences, Chiba, Japan.
Diabetes Metab Res Rev. 2017 Sep;33(6). doi: 10.1002/dmrr.2898. Epub 2017 Apr 18.
In East Asian countries, which have a high prevalence of underweight individuals, there is little information about the association between dietary factors and abnormal glucose tolerance during pregnancy. We examined the association between carbohydrate intake and moderately abnormal glucose tolerance in Japanese pregnant women.
We conducted a prospective study on 325 Japanese pregnant women without a diagnosis of diabetes mellitus prior to pregnancy. Dietary carbohydrate intake (% of total energy intake) was assessed using a 3-day dietary record during weeks 8-15 of pregnancy. Glucose tolerance was assessed by the 50 g glucose challenge test (GCT) during weeks 24-28 of pregnancy. A positive GCT result was defined by a 1-hour plasma concentration ≥ 7.8 mmol/L. Odds ratios of a positive GCT were calculated for the top and middle tertile categories of carbohydrate intake using the bottom category as reference.
Mean (standard deviation) body mass index at the first prenatal visit was 19.7 (1.9) kg/m , and 95 women were underweight. Seventy-four women had positive GCT results. Carbohydrate intake was negatively associated with a positive GCT result after adjusting for age, parity, body mass index at first prenatal visit, family history of diabetes mellitus, rate of gestational weight gain, energy intake, and dietary fiber intake (odds ratio for top category: 0.46 [95% CI, 0.23-0.93]).
These findings suggest that high carbohydrate intake was negatively associated with moderately abnormal glucose tolerance in a population with a high prevalence of underweight individuals.
东亚国家普遍存在体重过轻的人群，关于饮食因素与妊娠期间葡萄糖耐量异常的关系，相关信息有限。本研究旨在探讨日本孕妇碳水化合物摄入量与葡萄糖耐量中度异常的相关性。
本前瞻性研究纳入了 325 名妊娠前未被诊断为糖尿病的日本孕妇。通过妊娠第 8-15 周的 3 天饮食记录评估膳食碳水化合物摄入量（占总能量摄入的百分比）。妊娠第 24-28 周时采用 50g 葡萄糖负荷试验（GCT）评估葡萄糖耐量。将 1 小时血浆浓度≥7.8mmol/L 定义为 GCT 阳性。以碳水化合物摄入量最低组为参照，采用中间组和最高组分类来计算 GCT 阳性的优势比。
首次产前检查时的平均（标准差）体重指数为 19.7（1.9）kg/m ，95 名孕妇体重过轻。74 名孕妇的 GCT 结果阳性。在校正年龄、产次、首次产前检查时的体重指数、糖尿病家族史、体重增加率、能量摄入和膳食纤维摄入后，碳水化合物摄入量与 GCT 阳性结果呈负相关（最高组的优势比：0.46 [95%CI，0.23-0.93]）。
这些发现表明，在体重过轻人群高发的人群中，高碳水化合物摄入与葡萄糖耐量中度异常呈负相关。
