Haghighatdoost Fahimeh, Riahi Roya, Safari Shahla, Heidari Zahra
Isfahan Cardiovascular Research Center Cardiovascular Research Institute, Isfahan University of Medical Sciences Isfahan Iran.
Department of Biostatistics and Epidemiology School of Health, Isfahan University of Medical Sciences Isfahan Iran.
Food Sci Nutr. 2022 Sep 27;11(1):57-92. doi: 10.1002/fsn3.3042. eCollection 2023 Jan.
Although dietary factors are relevant modifiable risk factors for gestational diabetes mellitus (GDM), the exact association between dietary patterns and GDM remains controversial. Therefore, a systematic review and dose-response meta-analysis of observational studies were conducted to summarize the association between dietary patterns and risk of GDM. PubMed, Scopus, Web of Science, Cochrane Library, and EMbase databases were systematically searched for publications up to March 10, 2020. All observational studies which assessed the risk of GDM according to the categories of healthy or unhealthy dietary patterns derived by either a priori or a posteriori methods were eligible to be included. Pooled effect sizes for the highest vs. lowest categories of healthy/unhealthy dietary patterns were calculated using the random-effects model. Linear and nonlinear dose-response analyses were performed to determine dose-response associations. Thirty-one studies were included, of which 26 studies (80,849 participants) assessed healthy dietary pattern and 15 studies (32,965 participants) assessed the unhealthy dietary pattern. Individuals with a higher adherence to the healthy dietary pattern were less likely to be affected by GDM (RR = 0.86; 95% CI: 0.76-0.96; = 56.2%). There was a marginally significant association between unhealthy dietary patterns and GDM risk (RR = 1.28; 95% CI: 0.99-1.67; = 74.7). Significant linear associations were observed between healthy ( = .011) and unhealthy ( = .009) dietary patterns and GDM risk. Pregnant women with a healthier dietary pattern (a diet rich in fruits, vegetables, and whole grains) had lower risk for GDM. In contrast, higher adherence to an unhealthy dietary pattern was associated with increased risk of GDM. Further longitudinal studies are needed to confirm the results.
尽管饮食因素是妊娠期糖尿病（GDM）相关的可改变风险因素，但饮食模式与GDM之间的确切关联仍存在争议。因此，开展了一项观察性研究的系统评价和剂量反应荟萃分析，以总结饮食模式与GDM风险之间的关联。系统检索了PubMed、Scopus、Web of Science、Cochrane图书馆和EMbase数据库，截至2020年3月10日的出版物。所有根据先验或后验方法得出的健康或不健康饮食模式类别评估GDM风险的观察性研究均符合纳入标准。使用随机效应模型计算健康/不健康饮食模式最高类别与最低类别之间的合并效应量。进行线性和非线性剂量反应分析以确定剂量反应关联。纳入了31项研究，其中26项研究（80849名参与者）评估了健康饮食模式，15项研究（32965名参与者）评估了不健康饮食模式。更高依从健康饮食模式的个体受GDM影响的可能性较小（RR = 0.86；95%CI：0.76 - 0.96；I² = 56.2%）。不健康饮食模式与GDM风险之间存在边缘显著关联（RR = 1.28；95%CI：0.99 - 1.67；I² = 74.7）。在健康（P = 0.011）和不健康（P = 0.009）饮食模式与GDM风险之间观察到显著的线性关联。饮食模式更健康（富含水果、蔬菜和全谷物的饮食）的孕妇患GDM的风险较低。相比之下，更高依从不健康饮食模式与GDM风险增加相关。需要进一步的纵向研究来证实这些结果。
