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孕前叶酸补充的持续时间与妊娠期糖尿病风险

Duration of periconceptional folic acid supplementation and risk of gestational diabetes mellitus.

作者信息

Huang Lili, Yu Xiaoling, Li Li, Chen Yuanhua, Yang Yuanyuan, Yang Yuying, Hu Yan, Zhao Yangyang, Tang Haishan, Xu Dexiang, Zhao Mei

机构信息

School of Nursing, Anhui Medical University, Hefei, China.

Second Affiliated Hospital, Anhui Medical University, Hefei, China.

出版信息

Asia Pac J Clin Nutr. 2019;28(2):321-329. doi: 10.6133/apjcn.201906_28(2).0014.

Abstract

BACKGROUND AND OBJECTIVES

Increased consumption of folic acid is prevalent, raising concerns about possible adverse effects. This prospective study aimed to explore the associations between the duration of folic acid supplementation and the risk of gestational diabetes mellitus (GDM) in Chinese women.

METHODS AND STUDY DESIGN

A total of 326 pregnant women were prospectively included for detailed information on folic acid supplementation during pre-pregnancy and early pregnancy, lipid profiles at 16-18 weeks, and subsequent GDM diagnosis at 24-28 weeks. Associations among folic acid supplementation, lipid profiles, and risk of GDM were analyzed using linear and logistic regression models, adjusting for potential confounders.

RESULTS

The incidence of GDM in participants was 10.1%. We observed a U-shape relation between duration of folic acid supplementation and risk of GDM. Women who did not take folic acid and took folic acid for >90 days had a higher incidence of GDM compared to those who took folic acid for <=60 days. Moreover, lipid profiles were positively correlated with duration of folic acid supplementation and risk of GDM. After adjusting for demographic characters, energy and nutrients intakes and lipid profiles, the adjusted OR of GDM comparing taking folic acid for >90 days with taking folic acid for <=60 days was 3.45 (95% CI: 1.01, 11.8).

CONCLUSIONS

This prospective study indicate a positive association among prolonged folic acid supplementation, lipid profiles in the second trimester, and risk of GDM. Future studies are warranted to verify the causal relationship and underlying mechanisms.

摘要

背景与目的

叶酸摄入量增加的情况普遍存在,引发了对可能的不良影响的担忧。这项前瞻性研究旨在探讨中国女性补充叶酸的持续时间与妊娠期糖尿病(GDM)风险之间的关联。

方法与研究设计

前瞻性纳入了326名孕妇,以获取孕前和孕早期补充叶酸的详细信息、孕16 - 18周时的血脂水平以及孕24 - 28周时随后的GDM诊断情况。使用线性和逻辑回归模型分析叶酸补充、血脂水平与GDM风险之间的关联,并对潜在混杂因素进行校正。

结果

参与者中GDM的发病率为10.1%。我们观察到叶酸补充持续时间与GDM风险之间呈U形关系。与补充叶酸≤60天的女性相比,未补充叶酸和补充叶酸>90天的女性GDM发病率更高。此外,血脂水平与叶酸补充持续时间和GDM风险呈正相关。在调整了人口统计学特征、能量和营养素摄入量以及血脂水平后,补充叶酸>90天与补充叶酸≤60天相比,GDM的校正比值比为3.45(95%CI:1.01,11.8)。

结论

这项前瞻性研究表明,长期补充叶酸、孕中期血脂水平与GDM风险之间存在正相关。未来有必要进行研究以验证因果关系和潜在机制。

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