Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, United States; Diabetes Unit, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Diabetes Res Clin Pract. 2021 Jun;176:108869. doi: 10.1016/j.diabres.2021.108869. Epub 2021 May 23.
Evaluate the relationship between self-reported carbohydrate intake and oral glucose tolerance test (OGTT) results in pregnancy.
We measured carbohydrate intake using 24-hour dietary recall and performed a 2-hour 75-gram OGTT in 95 pregnant women with risk factors for gestational diabetes (GDM) at a median of 26 weeks' gestation. We tested for associations between carbohydrate intake in the 24 hours preceding the OGTT and 60-minute OGTT glucose, glucose at other timepoints, and glucose area under the curve (AUC) using linear regression, with adjustment for potential confounders.
We observed an inverse linear relationship between carbohydrate intake (median 237 grams [interquartile range: 196, 303]) and 60-minute OGTT glucose. For every 50 gram reduction in carbohydrate intake, there was an 8.9 mg/dl increase in 60-minute OGTT glucose (P < 0.01) in an adjusted model. Lower carbohydrate intake was also associated with higher 30-minute (adjusted β = -6.5 mg/dl, P < 0.01) and 120-minute OGTT glucose (adjusted β = -8.1 mg/dl, P = 0.01) and AUC (adjusted β = -767, P < 0.01).
Carbohydrate intake in the day preceding an OGTT in pregnancy is associated with post-load glucose values, with lower carbohydrate intake predicting higher glucose levels and higher carbohydrate intake predicting lower glucose levels. Carbohydrate restriction or excess before an OGTT may affect GDM diagnosis.
评估妊娠期间自我报告的碳水化合物摄入量与口服葡萄糖耐量试验（OGTT）结果之间的关系。
我们使用 24 小时膳食回忆法测量了碳水化合物的摄入量，并在妊娠 26 周中位数时对 95 名患有妊娠糖尿病（GDM）风险因素的孕妇进行了 2 小时 75 克 OGTT。我们使用线性回归检验了 OGTT 前 24 小时内碳水化合物摄入量与 60 分钟 OGTT 葡萄糖、其他时间点的葡萄糖和葡萄糖曲线下面积（AUC）之间的关联，并进行了潜在混杂因素的调整。
我们观察到碳水化合物摄入量（中位数 237 克[四分位距：196，303]）与 60 分钟 OGTT 葡萄糖之间存在负线性关系。在调整模型中，碳水化合物摄入量每减少 50 克，60 分钟 OGTT 葡萄糖增加 8.9mg/dl（P<0.01）。较低的碳水化合物摄入量也与较高的 30 分钟（调整β=-6.5mg/dl，P<0.01）和 120 分钟 OGTT 葡萄糖（调整β=-8.1mg/dl，P=0.01）和 AUC（调整β=-767，P<0.01）相关。
妊娠期间 OGTT 前一天的碳水化合物摄入量与负荷后葡萄糖值相关，碳水化合物摄入量越低，预测葡萄糖水平越高，碳水化合物摄入量越高，预测葡萄糖水平越低。OGTT 前的碳水化合物限制或过量可能会影响 GDM 的诊断。
