Prepregnancy habitual intake of vitamin D from diet and supplements in relation to risk of gestational diabetes mellitus: A prospective cohort study
孕前习惯从饮食以及补充剂中摄入的维生素D剂量与妊娠糖尿病风险的关系:一项前瞻性队列研究
Abstract
enBackground
Vitamin D may play a pivotal role in regulating insulin secretion and insulin sensitivity. However, the effect of vitamin D intake, either from the diet or from supplements, on the development of gestational diabetes mellitus (GDM) remains unclear. We prospectively examined the association of prepregnancy habitual intake of vitamin D from diet and supplements with the risk of incident GDM in a well-established cohort.
Methods
The present study was performed on 21 356 singleton pregnancies from 15 225 women in the Nurses’ Health Study II cohort. Diet information, including vitamin D intake from food sources and supplements, was assessed in 1991 and every 4 years thereafter by validated food frequency questionnaires. Log-binomial models with generalized estimating equations were used to estimate relative risks (RRs) and 95% confidence intervals (CIs).
Results
During 10 years of follow-up, 865 incident GDM cases were documented. After adjustment for age, parity, race/ethnicity, family history of diabetes, dietary and lifestyle factors, and body mass index, the RRs (95% CIs) of GDM risk associated with supplemental vitamin D intake of 0, 1–399, and ≥400 IU/day were 1.00 (reference), 0.80 (0.67–0.96), and 0.71 (0.56–0.90), respectively (Ptrend = 0.002). Dietary and total vitamin D intakes were also inversely associated with GDM risk, but the associations were not statistically significant.
Conclusions
Prepregnancy supplemental vitamin D intake was significantly and inversely associated with risk of GDM. This study indicates potential benefits of increasing vitamin D intake from supplements in the prevention of GDM in women of reproductive age.
Abstract
zh摘要
背景
维生素D在调节胰岛素分泌与胰岛素敏感性的过程中可能有重要作用。然而, 维生素D摄入量(无论是从饮食还是从补充剂)对妊娠糖尿病(gestational diabetes mellitus,GDM)发展的影响目前却尚未明确。我们在一个完善的队列中前瞻性调查了孕前习惯从饮食和补充剂中摄入的维生素D剂量与GDM发生风险之间的关系。
方法
当前这项研究对来自于护士健康队列研究II 中的15225名妇女所怀的21356次单胎妊娠进行了研究。从1991年开始, 此后每隔4年都要使用经过验证的食物频率问卷表来评估饮食信息, 包括从饮食来源以及从补充剂摄入的维生素D。使用对数二项式模型与广义估计方程来评估相对风险(relative risks,RRs)与95%置信区间(Cis)。
结果
在10年随访期间, 记录到有865名妇女发生了GDM。校正年龄、胎次、种族/民族、糖尿病家族史、饮食与生活方式因素以及体重指数后, 发现维生素D补充摄入量为0、1-399IU/天以及> 400 IU/天三组的妇女发生GDM风险的RRs(95% Cis)分别为1.00(参照值)、0.80(0.67-0.96)以及0.71(0.56-0.90)(Ptrend = 0.002)。饮食以及总维生素D的摄入量也与GDM的风险呈负相关, 但是这种相关性没有显著性的统计学意义。
结论
孕前补充的维生素D摄入量与GDM的发病风险呈显著负相关。这项研究结果表明, 育龄妇女从补充剂中增加维生素D的摄入对于预防GDM具有潜在的益处。
