Department of Clinical Epidemiology and Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
Department of Clinical Epidemiology and Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
Diabetes Care. 2021 Jan;44(1):217-223. doi: 10.2337/dc20-1607. Epub 2020 Nov 6.
To investigate the association of folate and vitamin B in early pregnancy with gestational diabetes mellitus (GDM) risk.
The data of this study were from a subcohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B measurements at recruitment (between 9 and 13 gestational weeks) and those with three samples available for glucose measurements under an oral glucose tolerance test. GDM was diagnosed between 24 and 28 weeks' gestation. Odds ratio (OR) and 95% CI of having GDM was used to quantify the association.
A total of 1,058 pregnant women were included, and GDM occurred in 180 (17.01%). RBC folate and vitamin B were significantly higher in pregnancies with GDM than those without GDM ( values were 0.045 and 0.002, respectively) and positively correlated with 1-h and 2-h serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM; OR (95% CI) was 1.73 (1.19-2.53) ( = 0.004). Compared with RBC folate <400 ng/mL, pregnancies with RBC folate ≥600 ng/mL were associated with ∼1.60-fold higher odds of GDM; the adjusted OR (95% CI) was 1.58 (1.03-2.41) ( = 0.033). A significant trend of risk effect on GDM risk across categories of RBC folate was observed ( = 0.021). Vitamin B was significantly associated with GDM risk (OR 1.14 per 100 pg/mL; = 0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B with GDM was observed.
Higher maternal RBC folate and vitamin B levels in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B is not significantly associated with GDM.
探讨妊娠早期叶酸和维生素 B 与妊娠期糖尿病（GDM）风险的关系。
本研究的数据来自上海孕前队列研究的一个子队列。我们纳入了在招募时（妊娠 9-13 周）进行红细胞（RBC）叶酸和维生素 B 测量且有三次口服葡萄糖耐量试验下葡萄糖测量值的妊娠，并纳入了这些妊娠。GDM 的诊断时间在 24-28 孕周之间。采用比值比（OR）和 95%置信区间（CI）来量化 GDM 的关联。
共有 1058 名孕妇被纳入研究，其中 180 名（17.01%）发生 GDM。与未发生 GDM 的孕妇相比，发生 GDM 的孕妇 RBC 叶酸和维生素 B 水平显著更高（ 值分别为 0.045 和 0.002），且与 1 小时和 2 小时血清葡萄糖呈正相关。妊娠早期每日补充叶酸会增加 GDM 的风险；OR（95%CI）为 1.73（1.19-2.53）（ = 0.004）。与 RBC 叶酸<400ng/mL 相比，RBC 叶酸≥600ng/mL 的妊娠与 GDM 发生的风险约增加 1.60 倍；调整后的 OR（95%CI）为 1.58（1.03-2.41）（ = 0.033）。RBC 叶酸水平的类别与 GDM 风险呈显著的趋势性相关（ = 0.021）。维生素 B 与 GDM 风险显著相关（每增加 100pg/mL 的 OR 为 1.14； = 0.002）。血清叶酸和 RBC 叶酸/维生素 B 百分位比值与 GDM 之间无显著相关性。
妊娠早期母体 RBC 叶酸和维生素 B 水平较高与 GDM 风险显著相关，而叶酸/维生素 B 的平衡与 GDM 无显著相关性。
