孕早期综合健康生活方式与妊娠期糖尿病风险：一项前瞻性队列研究。
Combined healthy lifestyle in early pregnancy and risk of gestational diabetes mellitus: A prospective cohort study.
作者信息
Wu Linjing, Ouyang Jing, Lai Yuwei, Wu Ping, Wang Yi, Ye Yixiang, Wang Jingyi, Hu Mengyan, Zhang Jijuan, Xu Jiajing, Yang Xue, Yuan Jiaying, Zhao Bin, Song Xingyue, Yan Shijiao, Lv Chuanzhu, Liu Gang, Pan An, Pan Xiong-Fei
机构信息
Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
出版信息
BJOG. 2023 Dec;130(13):1611-1619. doi: 10.1111/1471-0528.17548. Epub 2023 May 22.
OBJECTIVE
To examine the association of a combined healthy lifestyle in early pregnancy with gestational diabetes mellitus (GDM) risk.
DESIGN, SETTING AND POPULATION: A Chinese prospective cohort study with 6980 pregnant women.
METHODS
Individual modifiable lifestyle factors were assessed in early pregnancy and a combined lifestyle score was derived from the sum of the lifestyle factors, with a higher score indicating a healthier lifestyle. The association of a combined healthy lifestyle with GDM risk was examined.
MAIN OUTCOME MEASURES
Gestational diabetes mellitus was diagnosed in middle pregnancy according to the International Association of Diabetes and Pregnancy Study Group criteria or diagnoses in medical records.
RESULTS
Overall, 501 (7.2%) pregnant women were diagnosed with GDM. Being physically active (total energy expenditure in upper three quintiles, i.e. ≥100.1 metabolic equivalent of task [MET]-hours/week; odds ratio [OR] 0.76, 95% confidence interval [CI] 0.63-0.92), healthy diet (total intake of vegetables and fruits ≥5 times/day; OR 0.74, 95% CI 0.59-0.94), sufficient sleep (night-time sleep duration ≥7 hours/night; OR 0.66, 95% CI 0.48-0.90) and healthy weight (early-pregnancy BMI <24.0 kg/m ; OR 0.57, 95% CI 0.46-0.71) were associated with lower GDM risk. The GDM risk decreased linearly across the combined lifestyle score (P <0.001): women with 2, 3 and 4 lifestyle factors compared with those with 0-1 factor had 38% (OR 0.62, 95% CI 0.46-0.84), 57% (OR 0.43, 95% CI 0.31-0.58) and 66% (OR 0.34, 95% CI 0.22-0.52) lower risks of GDM, respectively.
CONCLUSION
A healthy lifestyle in early pregnancy was associated with a substantially lower GDM risk.
目的
探讨孕早期综合健康生活方式与妊娠期糖尿病（GDM）风险的关联。
设计、背景与人群：一项针对6980名孕妇的中国前瞻性队列研究。
方法
在孕早期评估个体可改变的生活方式因素，并根据这些生活方式因素的总和得出综合生活方式评分，评分越高表明生活方式越健康。研究综合健康生活方式与GDM风险的关联。
主要观察指标
根据国际糖尿病与妊娠研究组标准在孕中期诊断妊娠期糖尿病，或依据病历诊断。
结果
总体而言，501名（7.2%）孕妇被诊断为GDM。身体活跃（总能量消耗处于上三分位数，即≥100.1代谢当量任务[MET]-小时/周；比值比[OR]0.76，95%置信区间[CI]0.63 - 0.92）、健康饮食（蔬菜和水果总摄入量≥5次/天；OR 0.74，95% CI 0.59 - 0.94）、充足睡眠（夜间睡眠时间≥7小时/晚；OR 0.66，95% CI 0.48 - 0.90）和健康体重（孕早期体重指数<24.0 kg/m²；OR 0.57，95% CI 0.46 - 0.71）与较低的GDM风险相关。GDM风险随综合生活方式评分呈线性下降（P<0.001）：具有2、3和4种生活方式因素的女性与具有0 - 1种因素的女性相比，GDM风险分别降低38%（OR 0.62，95% CI 0.46 - 0.84）、57%（OR 0.43，95% CI 0.31 - 0.58）和66%（OR 0.34，95% CI 0.22 - 0.52）。
结论
孕早期的健康生活方式与显著降低的GDM风险相关。
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