妊娠中期孕妇水果、蔬菜摄入量与妊娠糖尿病风险的研究

STUDY ON THE RISK OF GESTATIONAL DIABETES MELLITUS AND CONSUMPTION OF FRUITS AND VEGETABLES DURING MID-PREGNANCY

目的探讨妊中期孕妇水果、蔬菜和果汁摄入量与妊娠期糖尿病(gestational diabetes mellitus,GDM)发病风险的关系。方法对象为2013年6月至2014年6月在武警总医院门诊产前检查的孕妇2987例,采用24h膳食回顾法和食物频次调查法,水果、蔬菜和果汁摄入量与GDM发病风险的关联采用COX比例风险回归模型分析,不同种类蔬菜、水果的摄入量的GDM发病率用单因素方差分析。结果全部2987例孕妇中,405例孕妇(405/2987,13.6%)被首次诊断为妊娠期糖尿病。COX比例风险回归分析:全部种类的水果和蔬菜摄入量与GDM发病风险并无相关性,但茎块类蔬菜和果汁摄入量与GDM发病风险呈正相关,苹果和橙子的摄入量与GDM发病风险呈负相关,除茎块类以外的蔬菜摄入量与GDM发病风险呈负相关,而葡萄和西瓜摄入量与GDM发病之间的相关关系为非线性:在前三个区间,GDM发病率随着摄入量的增加而降低,但葡萄和西瓜摄入量P75区间的孕妇GDM发病率明显高于前三个区间。结论孕期适量增加叶类蔬菜和某些水果的摄入量能降低GDM发病风险,但进食过多茎块类蔬果以及经常饮用果汁会增加孕妇患GDM的风险。

Objective To examine the association between habitual consumption of fruits, vegetables and fruit juices and the risk of gestational diabetes mellitus （GDM） in mid-pregnancy. Methods A total of 2,987 pregnant women were included between June 2013 and June 2014. Fruits, vegetables and fruit juices consumption during pregnancy was assessed using a 24h dietary recall and FFQ through an in-person interview. We used Cox proportional hazard regression models and One-Way ANOVA to assess the associations between fruits, vegetables and fruit juices consumption （in quintiles） and the risk of GDM adjusted for gestational age, family history of diabetes, physical activity, and the fiber and meat intakes. Results Among the 2,987 pregnant women, 405 were diagnosed having GDM. There was no association between the whole fruit and vegetable consumption and the risk of GDM. Potatoes and fruit juices consumptions were positively associated with the risk of GDM. Meanwhile, apple, orange and vegetables except for potatoes were inversely associated with the development of GDM. The association of the fruits with GDM risk was nonlinear. Conclusion Appropriate amount of fruit and vegetable intakes during pregnancy may prevent the development of GDM, whereas excess consumption of fruit juices and potatoes may be associated with an increased risk.