背景:越来越多的证据表明游离脂肪酸(FFA)与妊娠期糖尿病(GDM)有关。然而,大多数研究集中在几种特定类型的FFA上,例如α-亚麻酸(C18:3n3)和花生四烯酸(C20:4n6)或总水平的FFA。
目的:本研究旨在检验孕早期各种FFA与GDM风险之间的关系。
方法:参与者来自舟山孕妇队列(ZWPC)。进行了1:2巢式病例对照研究:按年龄将50名GDM母亲与100名无GDM母亲相匹配,孕前体重指数(BMI),月口服葡萄糖耐量试验(OGTT)和奇偶校验。37个FFA(包括17个饱和脂肪酸(SFA),8单不饱和脂肪酸(MUFA),通过气相色谱-质谱(GC-MS)测试了孕早期母体血浆中的10种多不饱和脂肪酸(PUFA)和2种反式脂肪酸(TFA))。使用条件逻辑回归模型评估FFA与GDM风险的相关性。
结果:9个FFA分别与GDM风险增加相关(P<0.05),4种FFA分别与GDM风险降低相关(P<0.05)。SFA风险评分与更高的GDM风险相关(OR=1.34,95%CI:1.12-1.60),以及UFA风险评分(OR=1.26,95%CI:1.11-1.44),MUFA风险评分(OR=1.70,95CI:1.27-2.26),PUFA风险评分(OR=1.32,95CI:1.09-1.59)和TFA风险评分(OR=2.51,95CI:1.23-5.13)。此外,检测了不同类型FFA风险评分对GDM的联合影响.例如,与SFA和UFA风险评分低的人群相比,SFA和UFA风险评分高的女性患GDM的风险最高(OR=8.53,95CI:2.41-30.24),而SFA风险评分低、UFA风险评分高、SFA风险评分高、UFA风险评分低的风险比分别为6.37(95CI:1.33-30.53)和4.25(95CI:0.97-18.70),分别。
结论:孕早期孕妇FFA与GDM风险呈正相关。此外,FFA对GDM风险有共同作用。
结论:孕早期FFA水平升高会增加GDM的风险。
BACKGROUND: Accumulating evidence shows that free fatty acids (FFA) are associated with gestational diabetes mellitus (GDM). However, most of the studies focus on a few specific types of FFA, such as α-linolenic acid (C18:3n3) and Arachidonic acid (C20:4n6) or a total level of FFA.
OBJECTIVE: This study aimed to test the association between a variety of FFAs during the first trimester and the risk of GDM.
METHODS: The participants came from the Zhoushan Pregnant Women Cohort (ZWPC). A 1:2 nested case-control study was conducted: fifty mothers with GDM were matched with 100 mothers without GDM by age, pre-pregnancy body mass index (BMI), month of oral glucose tolerance test (OGTT) and parity. Thirty-seven FFAs (including 17 saturated fatty acids (SFA), 8 monounsaturated fatty acids (MUFA), 10 polyunsaturated fatty acids (PUFA) and 2 trans fatty acids (TFA)) in maternal plasma during the first trimester were tested by Gas Chromatography-Mass Spectrometry (GC-MS). Conditional logistic regression models were performed to assess the associations of FFA with the risk of GDM.
RESULTS: Nine FFAs were respectively associated with an increased risk of GDM (P < 0.05), and four FFAs were respectively associated with a decreased risk of GDM (P < 0.05). SFA risk score was associated with a greater risk of GDM (OR = 1.34, 95% CI: 1.12-1.60), as well as UFA risk score (OR = 1.26, 95% CI: 1.11-1.44), MUFA risk score (OR = 1.70, 95%CI: 1.27-2.26), PUFA risk score (OR = 1.32, 95%CI: 1.09-1.59) and TFA risk score (OR = 2.51, 95%CI: 1.23-5.13). Moreover, joint effects between different types of FFA risk scores on GDM were detected. For instance, compared with those with low risk scores of SFA and UFA, women with high risk scores of SFA and UFA had the highest risk of GDM (OR = 8.53, 95%CI: 2.41-30.24), while the Odds ratio in those with a low risk score of SFA and high risk score of UFA and those with a high risk score of SFA and low risk score of UFA was 6.37 (95%CI:1.33- 30.53) and 4.25 (95%CI: 0.97-18.70), respectively.
CONCLUSIONS: Maternal FFAs during the first trimester were positively associated with the risk of GDM. Additionally, there were joint effects between FFAs on GDM risk.
CONCLUSIONS: Elevated FFA levels in the first trimester increased the risk of GDM.