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。
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.