早孕期游离脂肪酸与妊娠期糖尿病发病风险的关系：巢式病例对照研究。
Association of free fatty acid in first trimester with the risk of gestational diabetes mellitus: a nested case-control study.
机构信息
Zhoushan Maternal and Child Care Hospital, Zhoushan, China.
Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China.
出版信息
BMC Endocr Disord. 2024 Sep 9;24(1):182. doi: 10.1186/s12902-024-01714-1.
BACKGROUND
Accumulating evidence shows that free fatty acids (FFA) are associated with gestational diabetes mellitus (GDM). However, most of the studies focus on a few specific types of FFA, such as α-linolenic acid (C18:3n3) and Arachidonic acid (C20:4n6) or a total level of FFA.
OBJECTIVE
This study aimed to test the association between a variety of FFAs during the first trimester and the risk of GDM.
METHODS
The participants came from the Zhoushan Pregnant Women Cohort (ZWPC). A 1:2 nested case-control study was conducted: fifty mothers with GDM were matched with 100 mothers without GDM by age, pre-pregnancy body mass index (BMI), month of oral glucose tolerance test (OGTT) and parity. Thirty-seven FFAs (including 17 saturated fatty acids (SFA), 8 monounsaturated fatty acids (MUFA), 10 polyunsaturated fatty acids (PUFA) and 2 trans fatty acids (TFA)) in maternal plasma during the first trimester were tested by Gas Chromatography-Mass Spectrometry (GC-MS). Conditional logistic regression models were performed to assess the associations of FFA with the risk of GDM.
RESULTS
Nine FFAs were respectively associated with an increased risk of GDM (P < 0.05), and four FFAs were respectively associated with a decreased risk of GDM (P < 0.05). SFA risk score was associated with a greater risk of GDM (OR = 1.34, 95% CI: 1.12-1.60), as well as UFA risk score (OR = 1.26, 95% CI: 1.11-1.44), MUFA risk score (OR = 1.70, 95%CI: 1.27-2.26), PUFA risk score (OR = 1.32, 95%CI: 1.09-1.59) and TFA risk score (OR = 2.51, 95%CI: 1.23-5.13). Moreover, joint effects between different types of FFA risk scores on GDM were detected. For instance, compared with those with low risk scores of SFA and UFA, women with high risk scores of SFA and UFA had the highest risk of GDM (OR = 8.53, 95%CI: 2.41-30.24), while the Odds ratio in those with a low risk score of SFA and high risk score of UFA and those with a high risk score of SFA and low risk score of UFA was 6.37 (95%CI:1.33- 30.53) and 4.25 (95%CI: 0.97-18.70), respectively.
CONCLUSION
Maternal FFAs during the first trimester were positively associated with the risk of GDM. Additionally, there were joint effects between FFAs on GDM risk.
CONDENSATION
Elevated FFA levels in the first trimester increased the risk of GDM.
背景
越来越多的证据表明，游离脂肪酸（FFA）与妊娠糖尿病（GDM）有关。然而，大多数研究都集中在几种特定类型的 FFA 上，如α-亚麻酸（C18：3n3）和花生四烯酸（C20：4n6）或 FFA 的总水平。
目的
本研究旨在检验孕早期多种 FFA 与 GDM 风险之间的关系。
方法
参与者来自舟山孕妇队列（ZWPC）。采用 1:2 巢式病例对照研究：50 例 GDM 母亲按年龄、孕前体重指数（BMI）、口服葡萄糖耐量试验（OGTT）月份和产次与 100 例无 GDM 母亲匹配。采用气相色谱-质谱法（GC-MS）检测孕早期母体血浆中 37 种 FFA（包括 17 种饱和脂肪酸（SFA）、8 种单不饱和脂肪酸（MUFA）、10 种多不饱和脂肪酸（PUFA）和 2 种反式脂肪酸（TFA））。采用条件逻辑回归模型评估 FFA 与 GDM 风险之间的关联。
结果
有 9 种 FFA 分别与 GDM 风险增加相关（P<0.05），有 4 种 FFA 分别与 GDM 风险降低相关（P<0.05）。SFA 风险评分与 GDM 风险增加相关（OR=1.34，95%CI：1.12-1.60），UFA 风险评分（OR=1.26，95%CI：1.11-1.44）、MUFA 风险评分（OR=1.70，95%CI：1.27-2.26）、PUFA 风险评分（OR=1.32，95%CI：1.09-1.59）和 TFA 风险评分（OR=2.51，95%CI：1.23-5.13）也与 GDM 风险增加相关。此外，还检测到不同类型 FFA 风险评分对 GDM 的联合效应。例如，与 SFA 和 UFA 低风险评分的女性相比，SFA 和 UFA 高风险评分的女性 GDM 风险最高（OR=8.53，95%CI：2.41-30.24），而 SFA 低风险评分和 UFA 高风险评分以及 SFA 高风险评分和 UFA 低风险评分的女性的比值分别为 6.37（95%CI：1.33-30.53）和 4.25（95%CI：0.97-18.70）。
结论
孕早期母体 FFA 与 GDM 风险呈正相关。此外，FFA 对 GDM 风险存在联合效应。
结论
孕早期母体 FFA 与 GDM 风险呈正相关。此外，FFA 对 GDM 风险存在联合效应。
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