膳食胆固醇摄入对妊娠期糖尿病的影响

摘要

目的 研究妊娠期妇女孕前1年、孕早期、孕中期膳食胆固醇摄入对妊娠期糖尿病的影响.方法 收集2012年3月至2016年9月在山西医科大学第一医院产科住院分娩孕妇的一般人口学特征、妊娠期糖尿病诊断结果及膳食胆固醇摄入情况,根据对照组孕妇不同时期胆固醇摄入的P25、P50、P75将其分为4组.采用非条件logistic回归分析孕前1年、孕早期、孕中期膳食胆固醇摄入量与妊娠期糖尿病的关系,及不同年龄段孕妇膳食胆固醇摄入对妊娠期糖尿病发生的影响.结果 共纳入研究对象9 005人,其中妊娠期糖尿病1 388例.多因素分析结果显示,孕前1年胆固醇摄入量≥76.50 mg/d且孕中期摄入量为≥46.75 mg/d的孕妇患GDM的风险增加.按年龄分层后,年龄＜35岁孕妇的孕前1年和孕中期胆固醇摄入量≥76.50 mg/d是妊娠期糖尿病的危险因素(分别为OR=1.336,95％CI:1.083～1.647;OR=1.341,95％CI:1.087 ～ 1.654),孕妇年龄≥35岁组未发现膳食胆固醇摄入与妊娠期糖尿病发生有关.结论 妊娠期妇女孕前1年及孕中期膳食胆固醇摄入高均会增加妊娠期糖尿病的发生风险.%Objective To investigate the influence of dietary cholesterol intake on gestational diabetes mellitus (GDM),at one year prior to and first and second trimesters of pregnancy.Methods Between March 2012 and September 2016,the pregnant women from the First Affiliated Hospital of Shanxi Medical University were asked to fill in a set of questionnaires,by which information on general demographic characteristics,diagnosis of GDM and dietary cholesterol intake was collected.Unconditional logistic regression method was used to analyze the influence of dietary cholesterol intake on GDM,at one year prior to and first and second trimesters of pregnancy.The association on dietary cholesterol intake and GDM between age groups was also analyzed.Results Data on 9 005 subjects,including 1 388 pregnant women with GDM,was collected.When the amount of cholesterol intake was stratified into quartile,results from the unconditional logistic regression showed that dietary cholesterol intake appeared ≥76.50 mg/d,both in the periods of one year prior to and the second trimester of pregnancy.This amount of dietary cholesterol intake would increase the risk of GDM (one year prior to pregnant:OR=1.230,95％CI:1.018-1.485;second trimester:OR=1.228,95％C1:1.014-1.486).Women who took ≥76.50 mg/d of daily cholesterol during the period of one year prior to,or 46.75-76.50 mg/d during the second trimester of pregnancy,the risks of GDM (OR=4.644,95％CI:1.106-19.499) would increase.Women with daily cholesterol intake over 76.50 mg/d during the period of one year prior to or at the second trimester of pregnancy,there appeared a risk on GDM (OR=1.217,95％ CI:1.012-1.463).When maternal age was divided in two different subgroups and the cholesterol intake level was ≥76.50 mg/d both in the period of one year prior to pregnancy or at the second trimester,the risk of GDM appeared in the subgroup of ＜35 years old (OR=1.336,95％CI:1.083-1.647;OR=1.341,95％CI:1.087-1.654).However,no significant association was found in the maternal age group of ≥35 years old.Conclusion High level of dietary cholesterol intake would increase the risk of GDM,both in the period of one year prior to and at the second trimester of pregnancy.