Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.
J Diabetes. 2019 Sep;11(9):744-751. doi: 10.1111/1753-0407.12899. Epub 2019 Feb 14.
This study examined whether folate and vitamin B imbalance is associated with gestational diabetes mellitus (GDM) and explored interactions between B vitamin imbalance and maternal risk factors for GDM.
A cross-sectional study was performed in 406 Chinese pregnant women. Serum folate, vitamin B , and blood glucose concentrations were measured at 24 to 28 weeks gestation during GDM screening. A diagnosis of GDM was made based on International Association of Diabetes and Pregnancy Study Groups criteria (fasting plasma glucose [FPG] ≥5.1 mM, 1-hour plasma glucose ≥10.0 mM, or 2-hour plasma glucose ≥8.5 mM). Binary logistic regression was used to obtain odds ratios (ORs) after controlling for different confounders.
Higher folate levels were associated with higher glucose concentrations and a higher risk of GDM (OR 1.98; 95% confidence interval [CI] 1.00-3.90), whereas higher vitamin B levels were associated with lower FPG and a lower risk of GDM (OR 0.30; 95% CI 0.15-0.60). A higher folate: vitamin B ratio was associated with higher glucose and a higher risk of GDM (OR 3.08; 95% CI 1.63-5.83). The presence of both a higher folate: vitamin B ratio and advanced age further increased the OR to 2.13 (95% CI 1.09-4.15) with a significant additive interaction. Furthermore, a higher folate: vitamin B ratio and a higher prepregnancy body mass index (pp-BMI) were synergistically associated with an increased risk of GDM (OR 3.03; 95% CI 1.40-6.57).
An imbalance between folate and vitamin B , represented by a higher folate: vitamin B ratio, was highly associated with GDM risk, and this association could be further modified by maternal age and pp-BMI.
本研究旨在探讨叶酸和维生素 B 失衡是否与妊娠糖尿病（GDM）相关，并探索 B 族维生素失衡与 GDM 产妇危险因素之间的相互作用。
对 406 名中国孕妇进行横断面研究。在 GDM 筛查时，于妊娠 24-28 周检测血清叶酸、维生素 B 及血糖浓度。根据国际糖尿病与妊娠研究组（IADPSG）标准（空腹血糖[FPG]≥5.1mmol/L、1 小时血糖≥10.0mmol/L 或 2 小时血糖≥8.5mmol/L）诊断 GDM。采用二元逻辑回归控制不同混杂因素后，获得比值比（OR）。
较高的叶酸水平与较高的血糖浓度和较高的 GDM 风险相关（OR 1.98；95%置信区间[CI]1.00-3.90），而较高的维生素 B 水平与较低的 FPG 和较低的 GDM 风险相关（OR 0.30；95%CI 0.15-0.60）。较高的叶酸/维生素 B 比值与较高的血糖浓度和较高的 GDM 风险相关（OR 3.08；95%CI 1.63-5.83）。较高的叶酸/维生素 B 比值和较高的年龄同时存在时，会使 OR 进一步增加至 2.13（95%CI 1.09-4.15），具有显著的相加交互作用。此外，较高的叶酸/维生素 B 比值和较高的孕前体重指数（pp-BMI）与 GDM 风险增加呈协同关系（OR 3.03；95%CI 1.40-6.57）。
叶酸和维生素 B 之间的失衡，表现为较高的叶酸/维生素 B 比值，与 GDM 风险高度相关，且这种相关性可进一步被产妇年龄和 pp-BMI 所修饰。
