胰岛素血症和炎症性饮食模式显示出更强的妊娠糖尿病风险预测潜力

Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Gestational Diabetes Mellitus Risk

胰岛素血症和炎症性饮食模式显示出更强的妊娠糖尿病风险预测潜力

Authors: Ping Zu, Haixia Wang, Lei Zhang, Haoran Bian, Jingfeng Bian, Nan Jiang, Wei Luo, Min Xu, Jirong Xu, Xiaomin Jiang, Ruixue Tao, Peng Zhu

Source: Journal of Clinical Endocrinology & Metabolism

DOI: 10.1210/clinem/dgae238

Abstract

Context: The putative association between pro-inflammatory and hyperinsulinemic dietary patterns and susceptibility to gestational diabetes mellitus (GDM) remains unclear.

Objective: We aimed to compare the risk associated with the Mediterranean diet, as well as insulinemic and pro-inflammatory dietary patterns, in relation to the occurrence of GDM, and evaluate their predictive value.

Methods: We prospectively followed 8495 women from the Maternal and Infant Health cohort in Hefei, China (2015-2021). Using a food frequency questionnaire, we calculated the empirical dietary inflammatory pattern (EDIP), the empirical dietary index for hyperinsulinemia (EDIH) score, and the Mediterranean diet (MD) score. GDM was diagnosed based on a 2-hour 75-gram oral glucose tolerance test conducted between 24 to 28 weeks of gestation. Logistic regression was used to estimate the risk of GDM, while receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of the empirical dietary index for GDM.

Results: Participants who followed hyperinsulinemic or pro-inflammatory dietary patterns to the greatest extent had a higher risk of developing GDM. The odds ratio (OR) for the highest quartile compared to the lowest quartile were 1.39 (95% CI, 1.30-1.49) for EDIH and 2.40 (95% CI, 1.88-3.01) for EDIP. The OR for the lowest quartile compared to the highest quartile was 1.33 (95% CI, 1.14-1.55) for MD. The ROC curve analysis indicated that the combination of EDIP and EDIH (AUC = 0.81; 95% CI, 0.78-0.82; P = .003) can effectively predict the occurrence of GDM.

Conclusion: Utilizing both empirical dietary indexes, EDIP and EDIH, might offer a potentially more effective approach in preventing GDM when compared to solely focusing on adherence to the MD pattern.

Keywords: EDIH; EDIP; cohort study; diet; gestational diabetes mellitus.

摘要

背景：促炎症和高胰岛素血症饮食模式与妊娠糖尿病（GDM）易感性之间的假定关联仍不清楚。

研究目的：我们旨在比较地中海饮食、胰岛素分泌过多饮食模式和促炎症饮食模式与 GDM 发生相关的风险，并评估其预测价值。

研究方法：我们对中国合肥市母婴健康队列中的 8495 名妇女进行了前瞻性随访（2015-2021 年）。通过食物频率问卷，我们计算了经验性膳食炎症模式（EDIP）、高胰岛素血症经验性膳食指数（EDIH）评分和地中海饮食（MD）评分。GDM 的诊断依据是妊娠 24-28 周期间进行的 2 小时 75 克口服葡萄糖耐量试验。采用逻辑回归法估算 GDM 的风险，同时构建接收器操作特征曲线 (ROC) 来评估经验饮食指数对 GDM 的预测性能。

研究结果：最大程度地遵循高胰岛素血症或促炎饮食模式的受试者患 GDM 的风险较高。最高四分位数与最低四分位数相比，EDIH 的几率比（OR）为 1.39（95% CI，1.30-1.49），EDIP 的几率比（OR）为 2.40（95% CI，1.88-3.01）。与最高四分位数相比，最低四分位数的 MD OR 为 1.33（95% CI，1.14-1.55）。ROC 曲线分析表明，EDIP 和 EDIH 的组合（AUC = 0.81；95% CI，0.78-0.82；P =0.003）可有效预测 GDM 的发生。

结论：与只关注MD模式相比，利用EDIP和EDIH这两种经验性膳食指数可能是预防GDM的一种更有效的方法。

关键词：EDIH；EDIP；队列研究；饮食；妊娠糖尿病