Abstract：
OBJECTIVE: To systematically investigate the association between the dietary inflammatory index (DII) and gestational diabetes mellitus (GDM), with a focus on the role of BMI in this relationship.
METHODS: A comprehensive search was conducted in PubMed, Embase, Web of Science, The Cochrane Library, Medline, CINAHL Complete, Chinese Periodical Full-text Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and China Wanfang Database for rele-vant observational studies published up to August 2023. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The pooled effect size was calculated using a random-effects model. Sub-group and meta-regression analyses were performed to explore potential sources of heterogeneity.
RESULTS: The study included 54,058 participants from 10 studies. Pregnant women with a higher DII, indicating a pro-inflammatory diet, had a significantly increased risk of GDM compared to those with a lower DII, indicating an anti-inflammatory diet (pooled OR: 1.17, 95% CI: 1.01-1.36; I²=70%, p <0.001). Subgroup analyses revealed a stronger association in normal weight stratification (OR: 1.25, 95%CI: 1.04-1.51), case-control studies (OR: 1.45, 95%CI: 1.03-2.05), Asia (OR: 1.26, 95%CI: 1.10-1.43), Europe (OR: 1.27, 95%CI: 1.09-1.48), 3-day dietary record as a dietary assessment tool (OR: 1.30, 95%CI: 1.16-1.46), physical activity adjustment (OR: 1.28, 95%CI: 1.13-1.46), and energy intake adjustment (OR: 1.33, 95%CI: 1.19-1.48). Meta-regression analysis confirmed that geographical region significantly influenced heterogeneity between studies (p <0.05).
CONCLUSIONS: An elevated DII is independently linked to a higher risk of GDM, especially in women of normal weight.
METHODS: A comprehensive search was conducted in PubMed, Embase, Web of Science, The Cochrane Library, Medline, CINAHL Complete, Chinese Periodical Full-text Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and China Wanfang Database for rele-vant observational studies published up to August 2023. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The pooled effect size was calculated using a random-effects model. Sub-group and meta-regression analyses were performed to explore potential sources of heterogeneity.
RESULTS: The study included 54,058 participants from 10 studies. Pregnant women with a higher DII, indicating a pro-inflammatory diet, had a significantly increased risk of GDM compared to those with a lower DII, indicating an anti-inflammatory diet (pooled OR: 1.17, 95% CI: 1.01-1.36; I²=70%, p <0.001). Subgroup analyses revealed a stronger association in normal weight stratification (OR: 1.25, 95%CI: 1.04-1.51), case-control studies (OR: 1.45, 95%CI: 1.03-2.05), Asia (OR: 1.26, 95%CI: 1.10-1.43), Europe (OR: 1.27, 95%CI: 1.09-1.48), 3-day dietary record as a dietary assessment tool (OR: 1.30, 95%CI: 1.16-1.46), physical activity adjustment (OR: 1.28, 95%CI: 1.13-1.46), and energy intake adjustment (OR: 1.33, 95%CI: 1.19-1.48). Meta-regression analysis confirmed that geographical region significantly influenced heterogeneity between studies (p <0.05).
CONCLUSIONS: An elevated DII is independently linked to a higher risk of GDM, especially in women of normal weight.
摘要：
目的：系统探讨膳食炎症指数（DII）与妊娠期糖尿病（GDM）的关系。重点关注BMI在这种关系中的作用。
方法：在PubMed中进行了全面搜索，Embase,WebofScience,科克伦图书馆,Medline,CINAHL完成,中国期刊全文数据库,中国国家知识基础设施，中国生物医学文献数据库,和截至2023年8月出版的中国万方观测研究数据库。使用纽卡斯尔-渥太华量表评估纳入研究的质量。使用随机效应模型计算合并效应大小。进行亚组和荟萃回归分析以探索异质性的潜在来源。
结果：该研究包括来自10项研究的54,058名参与者。孕妇DII较高,表明促炎饮食，与DII较低的患者相比，GDM的风险显着增加，表明抗炎饮食(合并OR：1.17，95%CI：1.01-1.36；I²=70%，p<0.001)。亚组分析显示正常体重分层有更强的关联（OR：1.25，95CI：1.04-1.51），病例对照研究（OR：1.45，95CI：1.03-2.05），亚洲（OR：1.26，95CI：1.10-1.43），欧洲（OR：1.27，95CI：1.09-1.48），3天饮食记录作为饮食评估工具（OR：1.30，95CI：1.16-1.46），身体活动调整（OR：1.28，95CI：1.13-1.46），和能量摄入调整（OR：1.33，95CI：1.19-1.48）。Meta回归分析证实，地理区域显著影响研究间的异质性（p<0.05）。
结论：DII升高与GDM的高风险独立相关，尤其是体重正常的女性。
方法：在PubMed中进行了全面搜索，Embase,WebofScience,科克伦图书馆,Medline,CINAHL完成,中国期刊全文数据库,中国国家知识基础设施，中国生物医学文献数据库,和截至2023年8月出版的中国万方观测研究数据库。使用纽卡斯尔-渥太华量表评估纳入研究的质量。使用随机效应模型计算合并效应大小。进行亚组和荟萃回归分析以探索异质性的潜在来源。
结果：该研究包括来自10项研究的54,058名参与者。孕妇DII较高,表明促炎饮食，与DII较低的患者相比，GDM的风险显着增加，表明抗炎饮食(合并OR：1.17，95%CI：1.01-1.36；I²=70%，p<0.001)。亚组分析显示正常体重分层有更强的关联（OR：1.25，95CI：1.04-1.51），病例对照研究（OR：1.45，95CI：1.03-2.05），亚洲（OR：1.26，95CI：1.10-1.43），欧洲（OR：1.27，95CI：1.09-1.48），3天饮食记录作为饮食评估工具（OR：1.30，95CI：1.16-1.46），身体活动调整（OR：1.28，95CI：1.13-1.46），和能量摄入调整（OR：1.33，95CI：1.19-1.48）。Meta回归分析证实，地理区域显著影响研究间的异质性（p<0.05）。
结论：DII升高与GDM的高风险独立相关，尤其是体重正常的女性。
