Tranidou Antigoni, Tsakiridis Ioannis, Magriplis Emmanuela, Apostolopoulou Aikaterini, Chroni Violeta, Tsekitsidi Eirini, Kalaitzopoulou Ioustini, Pazaras Nikolaos, Chourdakis Michail, Dagklis Themistoklis
3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Biomedicines. 2024 Dec 29;13(1):57. doi: 10.3390/biomedicines13010057.
Limited evidence links maternal macronutrient intake to gestational diabetes mellitus (GDM) risk. Therefore, we evaluated these intakes both before and during pregnancy, comparing macronutrient data against the European Food and Safety Authorities' (EFSA) Dietary Reference Values (DRVs). Data were prospectively collected from the Greek BORN2020 epidemiologic pregnant cohort, which included 797 pregnant women, of whom 14.7% were diagnosed with GDM. A multinomial logistic regression model assessed the association between macronutrient intake and GDM, adjusting for maternal, lifestyle, and pregnancy-related factors. Women with GDM had higher maternal age (34.15 ± 4.48 vs. 32.1 ± 4.89 years), higher pre-pregnancy BMI (median 23.7 vs. 22.7 kg/m), and were more likely to smoke during mid-gestation (17.95% vs. 8.82%). Pre-pregnancy energy intake exceeding EFSA recommendations was associated with increased GDM risk (aOR = 1.99, 95%CI: 1.37-2.86). During mid-gestation, higher dietary fiber intake (aOR = 1.05, 95%CI: 1.00-1.10), higher protein intake (aOR = 1.02, 95% CI: 1.00-1.04), and higher protein percentage of energy intake (aOR = 1.08, 95%CI: 1.01-1.17) were all significantly associated with increased GDM risk. Changes from pre-pregnancy to pregnancy showed significant increases in dietary fiber intake (aOR = 1.07, 95%CI: 1.04-1.10), protein (aOR = 1.00, 95%CI: 1.00-1.01), fat (aOR = 1.00, 95%CI: 1.00-1.01), vegetable protein (aOR = 1.01, 95%CI: 1.00-1.03), animal protein (aOR = 1.00, 95%CI: 1.00-1.01), and monounsaturated fatty acid (MUFA) intake (aOR = 1.01, 95%CI: 1.00-1.02), all of which were associated with increased GDM risk. Energy intake above upper levels set by EFSA, as well as increased protein, MUFA, and fiber intake, although beneficial in balanced intakes, may negatively affect gestation by increasing GDM likelihood when consumed beyond requirements.
有限的证据表明孕妇的常量营养素摄入量与妊娠期糖尿病（GDM）风险相关。因此，我们评估了孕期前后的这些摄入量，并将常量营养素数据与欧洲食品安全局（EFSA）的膳食参考值（DRV）进行了比较。数据前瞻性地收集自希腊BORN2020流行病学孕妇队列，该队列包括797名孕妇，其中14.7%被诊断为GDM。多分类逻辑回归模型评估了常量营养素摄入量与GDM之间的关联，并对孕妇、生活方式和妊娠相关因素进行了调整。患有GDM的女性孕妇年龄较大（34.15±4.48岁 vs. 32.1±4.89岁），孕前BMI较高（中位数23.7 vs. 22.7 kg/m²），且在妊娠中期吸烟的可能性更大（17.95% vs. 8.82%）。孕前能量摄入超过EFSA建议与GDM风险增加相关（调整后比值比[aOR]=1.99，95%置信区间[CI]：1.37 - 2.86）。在妊娠中期，较高的膳食纤维摄入量（aOR = 1.05，95%CI：1.00 - 1.10）、较高的蛋白质摄入量（aOR = 1.02，95%CI：1.00 - 1.04）以及较高的蛋白质能量摄入百分比（aOR = 1.08，95%CI：1.01 - 1.17）均与GDM风险增加显著相关。从孕前到孕期的变化显示膳食纤维摄入量（aOR = 1.07，95%CI：1.04 - 1.10）、蛋白质（aOR = 1.00，95%CI：1.00 - 1.01）、脂肪（aOR = 1.00，95%CI：1.00 - 1.01）、植物蛋白（aOR = 1.01，95%CI：1.00 - 1.03）、动物蛋白（aOR = 1.00，95%CI：1.00 - 1.01）和单不饱和脂肪酸（MUFA）摄入量均显著增加（aOR = 1.01，95%CI：1.00 - 1.02），所有这些都与GDM风险增加相关。高于EFSA设定上限的能量摄入，以及蛋白质、MUFA和纤维摄入量的增加，尽管在均衡摄入时有益，但当摄入量超过需求时，可能会因增加GDM可能性而对妊娠产生负面影响。
