Aminianfar Azadeh, Zolfaghari Hamid, Soltani Sanaz, Hajianfar Hossein, Azadbakht Leila, Shahshahan Zahra, Esmaillzadeh Ahmad
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for Biochemistry and Nutrition in Metabolic Disease, Kashan University of Medical Sciences, Kashan, Iran.
Sci Rep. 2024 Dec 30;14(1):31571. doi: 10.1038/s41598-024-68125-z.
No study has examined the association between dietary insulin load (DIL) and insulin index (DII) with developing gestational diabetes mellitus (GDM) during pregnancy. This study aimed to investigate the association between DIL and DII and risk of GDM in a group of pregnant women in Iran. In this prospective cohort study, 812 pregnant in their first trimester were recruited and followed. Usual dietary intakes were measured using a validated 117-item semi-quantitative food frequency questionnaire at weeks 8-16 of gestations. DIL and DII were calculated based on earlier publications. GDM was diagnosed based on the results of a 50 g, 1 h oral glucose tolerance test at 24-28 weeks of gestation. Cox proportional hazards model was used to compute relative risks ratios (RRs) and 95% confidence intervals (CI) for GDM. Mean ± SD of age and BMI of study participants was 29.4 ± 4.84 y and 25.14 ± 4.08 kg/m, respectively at study baseline. Mean ± SD of DIL was 80,629 ± 29,328 and mean ± SD of DII was 40.23 ± 4.93. Overall, 28.4% (n = 231) of study population developed GDM at weeks 24-28 of pregnancy. After adjustment for potential confounding variables, we found that women in the highest quartile of DIL had 53% elevated risk of GDM (95% CI 1.003, 2.34; P-trend = 0.14) compared with those in the lowest quartile. Additional adjustment for weight gain during pregnancy did not alter the association (RR = 1.53; 95% CI 1.003, 2.34; P-trend = 0.14). Women with the greatest DII had a 23% non-significant elevated risk of GDM (95% CI 0.84, 1.82; P-trend = 0.55) compared to those with the lowest DII. We found that women with the highest DIL were at greater risk of developing GDM during pregnancy. No significant association was seen between DII and risk of GDM.
尚无研究探讨孕期膳食胰岛素负荷（DIL）和胰岛素指数（DII）与妊娠期糖尿病（GDM）发生之间的关联。本研究旨在调查伊朗一组孕妇中DIL和DII与GDM风险之间的关联。在这项前瞻性队列研究中，招募了812名孕早期孕妇并进行随访。在妊娠第8 - 16周，使用经过验证的117项半定量食物频率问卷测量日常饮食摄入量。DIL和DII根据早期出版物进行计算。根据妊娠24 - 28周时50克1小时口服葡萄糖耐量试验的结果诊断GDM。使用Cox比例风险模型计算GDM的相对风险比（RRs）和95%置信区间（CI）。在研究基线时，研究参与者的年龄和BMI的平均值±标准差分别为29.4±4.84岁和25.14±4.08kg/m²。DIL的平均值±标准差为80,629±29,328，DII的平均值±标准差为40.23±4.93。总体而言，28.4%（n = 231）的研究人群在妊娠24 - 28周时发生了GDM。在对潜在混杂变量进行调整后，我们发现DIL处于最高四分位数的女性患GDM的风险比最低四分位数的女性高53%（95%CI为1.003, 2.34；P趋势 = 0.14）。对孕期体重增加进行额外调整并未改变这种关联（RR = 1.53；95%CI为1.003, 2.34；P趋势 = 0.14）。与DII最低的女性相比，DII最高的女性患GDM的风险有23%的非显著升高（95%CI为0.84, 1.82；P趋势 = 0.55）。我们发现DIL最高的女性在孕期患GDM的风险更高。未发现DII与GDM风险之间存在显著关联。
