Abstract：
Epidemiologic studies have examined the association between dietary fatty acids and type 2 diabetes risk in general populations. Evidence regarding their associations with gestational diabetes mellitus (GDM) risk remains limited. This study aimed to evaluate prepregnancy fatty acids intake in relation to GDM risk.
3,725 pregnant women from the Xi\'an Birth Cohort Study who were free of previous GDM or pre-existing chronic diseases were included. Dietary intake of total fat and individual fatty acids (including saturated fatty acids [SFA], monounsaturated fatty acids [MUFA], polyunsaturated fatty acids [PUFA], and trans fatty acids) during the year preceding pregnancy was assessed by a validated food-frequency questionnaire before 16 weeks of gestation. GDM was confirmed based on the 75-g oral glucose tolerance test. Log-binomial or modified Poisson regression models were applied to estimate the relative risks (RRs) and 95 % confidence intervals (95%CIs) of GDM for fatty acids intake. Generalized linear regression was adopted for blood glucose levels with fatty acids intake.
644 (17.3 %) incident GDM cases were confirmed in our study. Participants in the highest intake of total fat substituting for carbohydrates had a 33 % reduced risk of GDM than those in the lowest intake (RR:0.67; 95%CI:0.55,0.81). For individual fatty acids, only PUFA intake was associated with a lower risk of GDM, with RR comparing extreme tertiles of 0.61 (95%CI:0.49,0.76). Each 2 % increase in energy from total fat and PUFA replacing carbohydrates decreased the risk of GDM by 6 % (95%CI:3 %,9 %) and 15 % (95%CI:9 %,21 %), respectively. Similar inverse associations with intake of total fat and PUFA were observed for blood glucose levels. Further analyses of SFA substitution showed that replacement of 2 % energy from SFA with PUFA and MUFA was associated with 26 % (RR:0.74; 95%CI:0.62,0.88) and 30 % (RR:0.70; 95%CI:0.50, 0.98) decreased risk of GDM, respectively.
Greater intake of total fat and PUFA before pregnancy was associated with lower risk of GDM when replacing carbohydrates. Substitution SFA with PUFA and MUFA was also inversely associated with GDM risk. These findings support the important role of optimal dietary fatty acids composition in the prevention of GDM.
3,725 pregnant women from the Xi\'an Birth Cohort Study who were free of previous GDM or pre-existing chronic diseases were included. Dietary intake of total fat and individual fatty acids (including saturated fatty acids [SFA], monounsaturated fatty acids [MUFA], polyunsaturated fatty acids [PUFA], and trans fatty acids) during the year preceding pregnancy was assessed by a validated food-frequency questionnaire before 16 weeks of gestation. GDM was confirmed based on the 75-g oral glucose tolerance test. Log-binomial or modified Poisson regression models were applied to estimate the relative risks (RRs) and 95 % confidence intervals (95%CIs) of GDM for fatty acids intake. Generalized linear regression was adopted for blood glucose levels with fatty acids intake.
644 (17.3 %) incident GDM cases were confirmed in our study. Participants in the highest intake of total fat substituting for carbohydrates had a 33 % reduced risk of GDM than those in the lowest intake (RR:0.67; 95%CI:0.55,0.81). For individual fatty acids, only PUFA intake was associated with a lower risk of GDM, with RR comparing extreme tertiles of 0.61 (95%CI:0.49,0.76). Each 2 % increase in energy from total fat and PUFA replacing carbohydrates decreased the risk of GDM by 6 % (95%CI:3 %,9 %) and 15 % (95%CI:9 %,21 %), respectively. Similar inverse associations with intake of total fat and PUFA were observed for blood glucose levels. Further analyses of SFA substitution showed that replacement of 2 % energy from SFA with PUFA and MUFA was associated with 26 % (RR:0.74; 95%CI:0.62,0.88) and 30 % (RR:0.70; 95%CI:0.50, 0.98) decreased risk of GDM, respectively.
Greater intake of total fat and PUFA before pregnancy was associated with lower risk of GDM when replacing carbohydrates. Substitution SFA with PUFA and MUFA was also inversely associated with GDM risk. These findings support the important role of optimal dietary fatty acids composition in the prevention of GDM.
摘要：
目的：流行病学研究已经研究了一般人群中膳食脂肪酸与2型糖尿病风险之间的关系。关于它们与妊娠糖尿病（GDM）风险相关的证据仍然有限。本研究旨在评估孕前脂肪酸摄入量与GDM风险的关系。
方法：纳入了来自西安出生队列研究的3,725名孕妇，这些孕妇没有先前的GDM或先前存在的慢性疾病。膳食总脂肪和个体脂肪酸(包括饱和脂肪酸[SFA]，单不饱和脂肪酸[MUFA]，多不饱和脂肪酸[PUFA]，和反式脂肪酸）在妊娠前16周之前通过经过验证的食物频率调查表评估了怀孕前一年的时间。根据75-g口服葡萄糖耐量试验确认GDM。采用对数二项或改进的Poisson回归模型估计GDM脂肪酸摄入的相对风险(RRs)和95%置信区间(95CIs)。血糖水平与脂肪酸摄入量的关系采用广义线性回归。
结果：我们的研究证实了644例（17.3%）GDM患者。摄入最高的总脂肪替代碳水化合物的参与者比摄入最低的参与者降低了33%的GDM风险(RR:0.67;95CI:0.55,0.81)。对于单个脂肪酸，只有PUFA的摄入与GDM的风险较低相关，RR比较极端三分位数为0.61（95CI：0.49,0.76）。总脂肪和PUFA替代碳水化合物的能量每增加2％，GDM的风险就会降低6％（95CI：3％，9%)和15%(95CI:9%，21%），分别。对于血糖水平，观察到与总脂肪和PUFA摄入量的类似负相关。对SFA替代的进一步分析表明，用PUFA和MUFA替代SFA的2％能量与26％（RR：0.74;95CI：0.62,0.88）和30％（RR：0.70;95CI：0.50，0.98）降低了GDM的风险，分别。
结论：怀孕前摄入更多的总脂肪和PUFA与替代碳水化合物时GDM的风险较低相关。用PUFA和MUFA替代SFA也与GDM风险呈负相关。这些发现支持最佳膳食脂肪酸组成在预防GDM中的重要作用。
方法：纳入了来自西安出生队列研究的3,725名孕妇，这些孕妇没有先前的GDM或先前存在的慢性疾病。膳食总脂肪和个体脂肪酸(包括饱和脂肪酸[SFA]，单不饱和脂肪酸[MUFA]，多不饱和脂肪酸[PUFA]，和反式脂肪酸）在妊娠前16周之前通过经过验证的食物频率调查表评估了怀孕前一年的时间。根据75-g口服葡萄糖耐量试验确认GDM。采用对数二项或改进的Poisson回归模型估计GDM脂肪酸摄入的相对风险(RRs)和95%置信区间(95CIs)。血糖水平与脂肪酸摄入量的关系采用广义线性回归。
结果：我们的研究证实了644例（17.3%）GDM患者。摄入最高的总脂肪替代碳水化合物的参与者比摄入最低的参与者降低了33%的GDM风险(RR:0.67;95CI:0.55,0.81)。对于单个脂肪酸，只有PUFA的摄入与GDM的风险较低相关，RR比较极端三分位数为0.61（95CI：0.49,0.76）。总脂肪和PUFA替代碳水化合物的能量每增加2％，GDM的风险就会降低6％（95CI：3％，9%)和15%(95CI:9%，21%），分别。对于血糖水平，观察到与总脂肪和PUFA摄入量的类似负相关。对SFA替代的进一步分析表明，用PUFA和MUFA替代SFA的2％能量与26％（RR：0.74;95CI：0.62,0.88）和30％（RR：0.70;95CI：0.50，0.98）降低了GDM的风险，分别。
结论：怀孕前摄入更多的总脂肪和PUFA与替代碳水化合物时GDM的风险较低相关。用PUFA和MUFA替代SFA也与GDM风险呈负相关。这些发现支持最佳膳食脂肪酸组成在预防GDM中的重要作用。
