Bahrami Ghazaleh, Hajian Aryan, Anjom-Shoae Javad, Hajhashemy Zahra, Askari Gholamreza, Marathe Chinmay S
Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
Faculty of Life Sciences, Food, Nutrition and Health, University of Bayreuth, Kulmbach, Germany.
Nutr J. 2025 Jul 22;24(1):117. doi: 10.1186/s12937-025-01186-6.
Previous studies investigating the relationship of dietary fat intake with gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) have yielded inconsistent findings. Therefore, the relationship between fat intake before and during pregnancy and risk of GDM and IGT was assessed.
A comprehensive search was conducted using electronic databases up to June 2024. Our selection criteria focused on observational studies that reported odds ratios (ORs)/ relative risks (RRs)/ hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between total, animal or plant fat intake and risks of GDM and IGT.
A total of 14 studies comprising 39,399 participants were included. Comparing the highest versus lowest intakes of total, animal, and plant fat revealed the summary RRs of 1.49 (95% CI: 1.20, 1.83), 1.56 (95% CI: 1.32, 1.85), and 1.26 (95% CI: 1.08, 1.47), respectively, indicating significant positive associations of total, animal and plant fat with GDM. Subgroup analysis indicated that total fat intake during pregnancy had a stronger association with GDM than pre-pregnancy intake. For animal and plant fat, significant associations were only observed for intake during pregnancy. Based on the linear dose-response analysis, each 5% energy increment in total dietary fat during pregnancy was associated with a 6% increased risk of GDM (RR = 1.06; 95% CI: 1.03, 1.10). The non-linear dose-response analysis indicated an increasing trend between total fat intake during pregnancy (23%-50% E) and the risk of GDM. However, there was no significant relationship between fat intake and IGT.
Higher total fat intake before and during pregnancy is directly and dose-dependently associated with increased GDM risk. The highest versus lowest values of animal and plant fat intakes during pregnancy were related to higher risk of GDM. No significant association was observed for IGT; however, the limited number of included studies especially on "pre-pregnancy" and the cross-sectional nature of several studies on "during pregnancy" prevent us from establishing causal relationships.
既往研究在探讨膳食脂肪摄入量与妊娠期糖尿病（GDM）及糖耐量受损（IGT）之间的关系时，结果并不一致。因此，本研究评估了妊娠前及妊娠期的脂肪摄入量与GDM和IGT风险之间的关系。
截至2024年6月，使用电子数据库进行了全面检索。我们的选择标准侧重于观察性研究，这些研究报告了总脂肪、动物脂肪或植物脂肪摄入量与GDM和IGT风险之间关联的比值比（OR）/相对风险（RR）/风险比（HR）及95%置信区间（CI）。
共纳入14项研究，涉及39399名参与者。比较总脂肪、动物脂肪和植物脂肪摄入量的最高值与最低值，汇总RR分别为1.49（95%CI：1.20，1.83）、1.56（95%CI：1.32，1.85）和1.26（95%CI：1.08，1.47），表明总脂肪、动物脂肪和植物脂肪与GDM均存在显著正相关。亚组分析表明，孕期总脂肪摄入量与GDM的关联比孕前摄入量更强。对于动物脂肪和植物脂肪，仅在孕期摄入量中观察到显著关联。基于线性剂量反应分析，孕期膳食总脂肪每增加5%的能量，GDM风险增加6%（RR = 1.06；95%CI：1.03，1.10）。非线性剂量反应分析表明，孕期总脂肪摄入量（23%-50%E）与GDM风险之间呈上升趋势。然而，脂肪摄入量与IGT之间无显著关系。
妊娠前及妊娠期较高的总脂肪摄入量与GDM风险增加直接相关且呈剂量依赖性。孕期动物脂肪和植物脂肪摄入量的最高值与最低值与较高的GDM风险相关。未观察到与IGT的显著关联；然而，纳入研究数量有限，尤其是关于“孕前”的研究，且多项关于“孕期”的研究具有横断面性质，这使得我们无法建立因果关系。
