孕早期膳食模式与妊娠期糖尿病的关联研究

目的 探讨孕早期不同膳食模式与妊娠期糖尿病(GDM)发生风险的关系以及在不同营养补充剂使用情况下二者的关联。方法 采用前瞻性出生队列研究设计。纳入2018年1月至2021年9月在西南地区15所妇幼保健院建卡的7 546名孕妇作为研究对象。收集研究对象社会人口学信息、膳食记录信息、营养补充剂使用情况以及口服葡萄糖耐量试验(OGTT)数据。采用主成分分析法提取膳食模式，并利用logistic回归模型探索孕早期膳食模式与GDM发生风险间的关系。结果 本研究提取了3种膳食模式，发现“综合型膳食模式”(OR=0.57,95%CI:0.41～0.78)和“高植物蛋白型膳食模式”(OR=0.65,95%CI:0.50～0.85)与GDM发生风险降低有关，而“高动物蛋白型膳食模式”(OR=2.90,95%CI:2.11～4.01)与GDM发生风险增加有关。在不同孕早期营养补充剂使用情况下，高动物蛋白型膳食模式与GDM的发病风险均显著相关。结论 孕早期的膳食模式对GDM的发生产生影响。无论在孕早期是否使用营养补充剂，高动物蛋白型膳食模式均提高GDM的发病风险。应加强对孕妇的营养教育，指导其选择健康的食物...

The relationship between gestational dietary patterns and gestational diabetes mellitus

Objective To investigate the association between different dietary patterns in early pregnancy and the risk of developing gestational diabetes mellitus(GDM), especially under different conditions of pregnancy nutrient supplement usage. Methods A prospective cohort study design was used. Seventy-five hundred and forty-six pregnant women who had their patient documents established at 15 maternal and child health hospitals in the southwest region from January 2018 to September 2021 were recruited as study participants. Dietary information and nutrient supplement usage situation were collected. Oral glucose tolerance test(OGTT)was applied to examine the development of GDM. Dietary pattern was extracted by principal component analysis. The impact of the dietary pattern in early pregnancy on the risk of GDM was estimated by logistic regression models. Results Three dietary patterns including balanced diet, high animal protein diet and high plant protein diet were identified. We found that balanced diet(OR=0.57, 95%CI:0.41-0.78)and high plant protein diet(OR=0.65, 95%CI:0.50-0.85)were related to a reduced risk of GDM, while high animal protein diet(OR=2.90, 95%CI:2.11-4.01)was associated with an increased risk of GDM. In addition, the relationship between high animal protein diet and risk of GDM remained significant in different conditions of pregnancy nutrient supplement usage. Conclusion Dietary patterns in early pregnancy affect the occurrence of GDM. High animal protein diet is significantly associated with the risk of GDM, regardless of early pregnancy supplement usage. Nutritional education for pregnant women should be tailored accordingly in the future.