Department of Gynecology, The First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China.
Medicine (Baltimore). 2023 Aug 11;102(32):e34740. doi: 10.1097/MD.0000000000034740.
Gestational Diabetes Mellitus (GDM) is a significant health concern in pregnant women and their offspring. Although Vitamin C is known to play a role in maintaining normal physiological processes, its relationship with GDM has not been fully elucidated.
We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, analyzing data from 15 studies selected from PubMed, Embase, Web of Science, and the Cochrane Library up to May 16, 2023. These studies were selected based on inclusion criteria such as study design, outcome of interest, exposure factor, and data extractability. Quality assessment was performed using the Newcastle-Ottawa Scale. We assessed the heterogeneity between studies and conducted a sensitivity analysis.
Data from 10,131 subjects, including 1304 diagnosed GDM cases, were analyzed. The meta-analysis showed that women in the low Vitamin C exposure group had higher odds of developing GDM (odds ratio 2.72, 95% CI:1.24-4.19). There was a greater likelihood of increased GDM risk with lower Vitamin C exposure (standardized mean difference: -0.71, 95% CI [-1.07 -0.36]). Subgroup analysis revealed that both internal and external Vitamin C exposure, along with exposure during the second or third trimester of pregnancy, was associated with higher GDM incidence rates under low Vitamin C exposure. Sensitivity analysis confirmed the robustness of the results, and no significant publication bias was detected.
Low Vitamin C exposure during pregnancy may increase the risk of GDM. Given these findings, it could be beneficial for pregnant women to increase their intake of Vitamin C-rich foods and to ensure adequate blood Vitamin C levels as a preventive measure against GDM.
妊娠期糖尿病（GDM）是孕妇及其后代的一个重大健康问题。尽管维生素 C 已知在维持正常生理过程中发挥作用，但它与 GDM 的关系尚未完全阐明。
我们按照系统评价和荟萃分析的首选报告项目指南进行了系统评价和荟萃分析，分析了截至 2023 年 5 月 16 日从 PubMed、Embase、Web of Science 和 Cochrane Library 中选择的 15 项研究的数据。这些研究是根据研究设计、感兴趣的结果、暴露因素和数据可提取性等纳入标准选择的。使用纽卡斯尔-渥太华量表进行质量评估。我们评估了研究之间的异质性并进行了敏感性分析。
对包括 1304 例确诊 GDM 病例在内的 10131 名受试者的数据进行了分析。荟萃分析表明，维生素 C 低暴露组的女性发生 GDM 的几率更高（比值比 2.72，95%置信区间：1.24-4.19）。维生素 C 低暴露时，GDM 风险增加的可能性更大（标准化均数差：-0.71，95%置信区间[-1.07-0.36]）。亚组分析表明，内源性和外源性维生素 C 暴露，以及妊娠第二或第三期暴露，与低维生素 C 暴露下 GDM 发生率升高有关。敏感性分析证实了结果的稳健性，且未发现显著的发表偏倚。
妊娠期间维生素 C 低暴露可能增加 GDM 的风险。鉴于这些发现，孕妇增加富含维生素 C 的食物摄入并确保充足的血液维生素 C 水平可能对预防 GDM 有益。
