母孕期膳食模式与双胎妊娠中妊娠期糖尿病发病风险的关系：一项前瞻性双胎妊娠出生队列研究。
Maternal dietary patterns and risk of gestational diabetes mellitus in twin pregnancies: a longitudinal twin pregnancies birth cohort study.
机构信息
Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.
出版信息
Nutr J. 2020 Feb 10;19(1):13. doi: 10.1186/s12937-020-00529-9.
BACKGROUND
Gestational diabetes mellitus (GDM) is correlated with an increased risk of adverse perinatal outcomes for both the mother and offspring. Previous research has reported correlations between maternal dietary patterns and GDM, but such evidence for twin pregnancies is lacking. This study aimed to identify maternal dietary patterns in the second trimester and investigate their relationships with the risk of GDM among women who were pregnant with twins in China.
METHODS
A longitudinal twin pregnancies birth cohort study of women who were pregnant with twins in China was conducted. Maternal dietary intake in the second trimester was recorded by using a food frequency questionnaire prior to the diagnosis of GDM among participants from the prospective twin pregnancies birth cohort in Chongqing City. GDM was diagnosed with a 75 g 2-h oral glucose tolerance test at 23-26 weeks of gestation. Dietary patterns were identified by principal components analysis, and the correlations between dietary pattern and GDM were examined using multivariable logistic regression analyses.
RESULTS
Of the 324 participants, 101 (31.2%) were diagnosed with GDM. Four dietary patterns were identified: a vegetable-based pattern, a poultry-and-fruit-based pattern, a sweet-based pattern and a plant-protein-based pattern. Multivariate analysis showed that none of the dietary patterns were correlated with the risk of GDM among women who were pregnant with twins, but the sweet-based dietary pattern, which was associated with a higher GDM risk for quartile 4 versus quartile 1 (OR 2.69; 95% CI: 1.09, 6.66) among non-overweight women (prepregnancy BMI < 24.0).
CONCLUSION
Dietary patterns were not correlated with later GDM risk among women who were pregnant with twins in western China, whereas a high intake of sweets was associated with a higher risk for GDM among women who were not overweight prior to pregnancy.
TRIAL REGISTRATION
ChiCTR-OOC-16008203. Retrospectively registered on 1 April 2016.
背景
妊娠糖尿病（GDM）与母婴围产期不良结局的风险增加相关。先前的研究报告了母体饮食模式与 GDM 之间的相关性，但双胞胎妊娠的证据尚缺乏。本研究旨在确定中国双胞胎妊娠女性孕中期的母体饮食模式，并探讨其与 GDM 风险的关系。
方法
在中国进行了一项纵向双胞胎妊娠出生队列研究。在重庆市前瞻性双胞胎妊娠出生队列的参与者中，在 GDM 诊断前使用食物频率问卷记录了孕中期的母体饮食摄入。GDM 是通过 23-26 孕周的 75g 2 小时口服葡萄糖耐量试验诊断的。采用主成分分析确定饮食模式，采用多变量 logistic 回归分析检查饮食模式与 GDM 的相关性。
结果
在 324 名参与者中，有 101 名（31.2%）被诊断为 GDM。确定了 4 种饮食模式：以蔬菜为基础的模式、以禽肉和水果为基础的模式、以甜食为基础的模式和以植物蛋白为基础的模式。多变量分析表明，在双胞胎妊娠女性中，没有任何一种饮食模式与 GDM 风险相关，但在非超重女性（孕前 BMI<24.0）中，与 quartile 4 相比 quartile 1 的 GDM 风险更高（OR 2.69；95%CI：1.09，6.66）的甜食饮食模式与 GDM 风险相关。
结论
在中国西部，饮食模式与双胞胎妊娠女性的晚期 GDM 风险无关，而在孕前不超重的女性中，甜食摄入较高与 GDM 风险增加相关。
试验注册
ChiCTR-OOC-16008203。于 2016 年 4 月 1 日进行了回顾性注册。
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