产后碳水化合物摄入量与口服葡萄糖耐量试验结果。
Carbohydrate Intake and Oral Glucose Tolerance Test Results in the Postpartum Period.
机构信息
Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA.
Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
出版信息
J Clin Endocrinol Metab. 2023 Sep 18;108(10):e1007-e1012. doi: 10.1210/clinem/dgad234.
CONTEXT
The American Diabetes Association (ADA) recommends a 3-day preparatory diet prior to a diagnostic oral glucose tolerance test (OGTT), a test often recommended in postpartum individuals with a history of gestational diabetes (GDM).
OBJECTIVE
Evaluate the relationship between carbohydrate intake and OGTT glucose in 2 cohorts of postpartum individuals.
METHODS
We performed analyses of postpartum individuals from 2 prospective studies with recent GDM (Balance after Baby Intervention, BABI, n = 177) or risk factors for GDM (Study of Pregnancy Regulation of INsulin and Glucose, SPRING, n = 104) .We measured carbohydrate intake using 24-hour dietary recalls (SPRING) or Food Frequency Questionnaire (BABI) and performed 2-hour 75-g OGTTs. The main outcome measure was 120-minute post-OGTT glucose.
RESULTS
There was no relationship between carbohydrate intake and 120-minute post-OGTT glucose level in either study population (SPRING: β = 0.03, [-5.5, 5.5] mg/dL, P = .99; BABI: β = -3.1, [-9.5, 3.4] mg/dL, P = .35). Adding breastfeeding status to the model did not change results (SPRING β = -0.14, [-5.7, 5.5] mg/dL, P = .95; BABI β = -3.9, [-10.4, 2.7] mg/dL, P = .25). There was, however, an inverse relationship between glycemic index and 120-minute post OGTT glucose (BABI: β = -1.1, [-2.2, -0.03] mg/dL, P = .04).
CONCLUSION
Carbohydrate intake is not associated with post-OGTT glucose levels among postpartum individuals. Dietary preparation prior to the OGTT may not be necessary in this population.
背景
美国糖尿病协会（ADA）建议在诊断口服葡萄糖耐量试验（OGTT）前进行为期 3 天的预备饮食，该试验常用于有妊娠期糖尿病（GDM）病史的产后人群。
目的
评估 2 组产后人群中碳水化合物摄入量与 OGTT 葡萄糖之间的关系。
方法
我们对最近患有 GDM（平衡后婴儿干预，BABI，n = 177）或 GDM 危险因素（妊娠胰岛素和葡萄糖调节研究，SPRING，n = 104）的 2 项前瞻性研究中的产后个体进行了分析。我们使用 24 小时膳食回忆（SPRING）或食物频率问卷（BABI）测量碳水化合物摄入量，并进行 2 小时 75g OGTT。主要观察指标是 OGTT 后 120 分钟的血糖。
结果
在这两个研究人群中，碳水化合物摄入量与 120 分钟 OGTT 后血糖水平均无相关性（SPRING：β=0.03，[-5.5，5.5]mg/dL，P=0.99；BABI：β=-3.1，[-9.5，3.4]mg/dL，P=0.35）。将母乳喂养状态添加到模型中并未改变结果（SPRINGβ=-0.14，[-5.7，5.5]mg/dL，P=0.95；BABIβ=-3.9，[-10.4，2.7]mg/dL，P=0.25）。然而，OGTT 后血糖与血糖指数呈负相关（BABI：β=-1.1，[-2.2，-0.03]mg/dL，P=0.04）。
结论
碳水化合物摄入量与产后个体 OGTT 后血糖水平无关。在该人群中，OGTT 前的饮食准备可能不是必需的。
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