Zhang Junli, Dong Youlian
Department of Obstetrics, Guangyuan Central Hospital, Sichuan Province, China.
Department of Obstetrics, the First People's Hospital of Xiaoshan District, Hangzhou, China.
Food Nutr Res. 2025 Jul 24;69. doi: 10.29219/fnr.v69.10986. eCollection 2025.
Gestational diabetes mellitus (GDM) is one of the most common metabolic complications during pregnancy, and is associated with a significantly increased risk of postpartum chronic kidney disease (CKD). Although a low-carbohydrate diet (LCD) is recommended for glycaemic management in GDM patients, its long-term impact on kidney health remains unclear.
To address this knowledge gap, this study aimed to investigate the association between LCD and the risk of CKD in women with a history of GDM, providing evidence for optimising postpartum dietary intervention strategies.
GDM data from National Health and Nutrition Examination Survey database (2009-2018) were used, with LCD as an independent variable and CKD as a dependent variable. Univariate and multivariate logistic regression analyses were applied to investigate factors related to CKD. Stratified and sub-group analyses were conducted to investigate association of LCD with CDK. Restricted cubic splines (RCS) were utilised to analyse non-linear relationship between the two variables.
There were 701 samples in all (CKD: = 130; non-CKD: = 571). The LCD score and CKD risk were shown to have a significant positive association (Odds Ratio [OR] > 1, < 0.05) in multivariate weighted logistic regression model. The link between LCD score and CKD was strongly impacted by race, body mass index (BMI), and smoking status ( for interaction < 0.05). In patients who presently smoke and use alcohol, stratified analysis showed a substantial positive correlation ( < 0.05) between LCD score and CKD risk. RCSs curve indicated a potential linear relationship (-non-linear = 0.9561) between risk of LCD and CKD, with an LCD score of 10 serving as the criterion threshold for CKD risk and OR < 1 when LCD < 10, signifying a protective factor.
Among women with GDM, higher LCD scores showed a significant positive correlation with CKD risk, particularly in sub-groups with smoking or alcohol consumption habits. The study suggests the need for careful evaluation of the long-term renal safety of LCD and highlights the importance of developing individualised dietary plans for high-risk populations.
妊娠期糖尿病（GDM）是孕期最常见的代谢并发症之一，与产后慢性肾脏病（CKD）风险显著增加相关。尽管推荐低碳水化合物饮食（LCD）用于GDM患者的血糖管理，但其对肾脏健康的长期影响仍不明确。
为填补这一知识空白，本研究旨在调查LCD与有GDM病史女性的CKD风险之间的关联，为优化产后饮食干预策略提供证据。
使用来自国家健康与营养检查调查数据库（2009 - 2018年）的GDM数据，将LCD作为自变量，CKD作为因变量。应用单因素和多因素逻辑回归分析来研究与CKD相关的因素。进行分层和亚组分析以研究LCD与CKD的关联。利用限制立方样条（RCS）分析两个变量之间的非线性关系。
总共701个样本（CKD： = 130；非CKD： = 571）。在多因素加权逻辑回归模型中，LCD评分与CKD风险呈显著正相关（优势比[OR] > 1， < 0.05）。LCD评分与CKD之间的联系受种族、体重指数（BMI）和吸烟状况的强烈影响（交互作用的 < 0.05）。在目前吸烟和饮酒的患者中，分层分析显示LCD评分与CKD风险之间存在显著正相关（ < 0.05）。RCS曲线表明LCD风险与CKD之间存在潜在线性关系（-非线性 = 0.9561），以LCD评分为10作为CKD风险的标准阈值，当LCD < 10时OR < 1，表明是一个保护因素。
在患有GDM的女性中，较高的LCD评分与CKD风险呈显著正相关，特别是在有吸烟或饮酒习惯的亚组中。该研究表明需要仔细评估LCD的长期肾脏安全性，并强调为高危人群制定个性化饮食计划的重要性。
