孕妇妊娠期膳食酸负荷与妊娠糖尿病关系研究  

Study of the relationship between dietary acid load and gestational diabetes mellitus in pregnant women

作　　者：房玥 吴婷婷[1] 陈黎慧 徐超英 曹冰林 张雅斓 FANG Yue;WU Tingting;CHEN Lihui;XU Chaoying;CAO Binglin;ZHANG Yalan(Suzhou Ninth Hospital Affiliated to Soochow University,Suzhou,Jiangsu 215200,China)

机构地区：[1]苏州大学附属苏州九院,江苏苏州215200

出　　处：《华南预防医学》2024年第12期1115-1119,共5页South China Journal of Preventive Medicine

基　　金：江苏省妇幼健康科研项目(F201830);2020年苏州市第九人民医院院级科研立项(YK202044)。

摘　　要：目的 探讨孕妇妊娠期膳食酸负荷与妊娠期糖尿病(GDM)风险间的关系。方法 采用前瞻性研究,于苏州大学附属苏州九院招募1 788名孕妇为研究对象。在胎龄小于20周的情况下,使用半定量食物频率问卷(FFQ)评估74种常见食物并计算膳食摄入量。通过潜在肾酸负荷(PRAL)、净内源性产酸量(NEAP)和动物蛋白与钾的比率(A∶P比)3项指标估算膳食酸负荷。妊娠24~28周时,在孕妇禁食8 h后进行2 h口服75 g葡萄糖的葡萄糖耐量试验(OGTT)以诊断GDM。结果 孕妇妊娠期PRAL、NEAP和A∶P比分别为(0.9±11.2) mEq/d、(44.3±17.7)mEq/d和(9.7±6.2)。膳食酸负荷与红肉、家禽、鱼和鸡蛋的摄入量呈正相关,与蔬菜、水果、坚果和豆类的摄入量呈负相关(均P<0.05)。与膳食酸负荷的最低三分位数和最高三分位数相比,包括PRAL评分(OR=2.27,95%CI:1.37,3.69,P=0.002),NEAP评分(OR=2.03,95%CI:1.22,3.28,P=0.011)和A∶P比值(OR=2.12,95%CI:1.33,3.35,P=0.004),均显著增加了GDM风险。膳食酸负荷与负荷后1 h血糖浓度(PBG)和2 h PBG的升高相关(均P<0.05)。结论 孕期膳食酸负荷与孕妇GDM风险间存在正相关,减少膳食酸负荷可能是降低GDM发生的一种有效的预防策略。Objective To investigate the relationship between dietary acid load and gestational diabetes mellitus(GDM)risk in pregnant women.Methods A prospective study was conducted in 1788 pregnant women recruited from Su⁃zhou Ninth Hospital Affiliated to Soochow University.The semi-quantitative Food Frequency Questionnaire(FFQ)was used to assess dietary intake for 74 common daily foods at a gestational age of fewer than 20 weeks.The potential renal acid load(PRAL),net endogenous acid production(NEAP),and the ratio of animal protein to potassium(A∶P ratio)were used to estimate dietary acid load.A glucose tolerance test(OGTT)of 75 grams of glucose orally administered for 2 hours after an 8-hour fast was performed to diagnose GDM at 24-28 weeks of gestation.Results The values of the PRAL,NEAP,and A∶P ratio were(0.9±11.2)mEq/day,(44.3±17.7)mEq/day,and(9.7±6.2),respectively.The dietary acid load was signifi⁃cantly positively correlated with the intake of red meat,poultry,fish,and eggs,and negatively correlated with the intake of vegetables,fruits,nuts,and legumes(all P<0.05).The lowest and highest quantiles of dietary acid load were compared,in⁃cluding the PRAL(OR=2.27,95%CI:1.37,3.69,P=0.002),NEAP(OR=2.03,95%CI:1.22,3.28,P=0.011),and A∶P ra⁃tio(OR=2.12,95%CI:1.33,3.35,P=0.004)significantly increased the risk of GDM.In addition,the dietary acid load was correlated with an increase in postprandial blood glucose(PBG)at 1 hour and PBG at 2 hours after load(both P<0.05).Conclusion There is a positive correlation between dietary acid load during pregnancy and the risk of GDM in pregnant women,suggesting that reducing dietary acid load is an effective preventive strategy to reduce the incidence of GDM.

关 键 词：膳食酸负荷 妊娠糖尿病 前瞻性队列 

分 类 号：R153.1[医药卫生—营养与食品卫生学]