摘要
目的探究孕期营养素摄入、食物组及膳食模式对妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)发病风险的影响。方法2018年10月至2019年1月在上海市复旦大学附属妇产科医院建立孕期队列,于孕中期采用3d24h膳食记录法收集孕妇食物摄入种类和数量。以1:2匹配巢式病例对照的研究方法,选择孕中期至分娩结束诊断为HDP病例67例和正常对照孕妇134例,应用先验法(dietary approach to stop hypertension,DASH膳食)及后验法(因子分析)建立膳食模式,采用条件Logistic回归法分析营养素、食物组及膳食模式与HDP发病风险的相关性。结果膳食营养素中,HDP组的能量、蛋白质、总脂肪、硫胺素、锌、脂肪酸、饱和脂肪酸(saturated fatty acid,SFA)、单不饱和脂肪酸(monounsaturated fatty acid,MUFA)及多不饱和脂肪酸(polyunsaturated fatty acid,PUFA)的摄入量高于对照组。经多因素Logistic回归分析,能量(OR=18.646,95%CI:4.215,82.490,P<0.001)、硫胺素(OR=10.738,95%CI:1.853,62.220,P=0.008)摄入与HDP发病风险存在正相关。食物组中,HDP组的畜肉类及其制品、饮料类的摄入量高于对照组。饮料类与HDP发病风险存在正相关(OR=3.697,95%CI:1.168,11.710,P=0.026)。先验法膳食模式中,HDP组与对照组的DASH膳食评分未发现统计学差异,DASH膳食评分与HDP发病风险存在负相关(OR=0.149,95%CI:0.030,0.735,P=0.019)。后验法膳食模式中,因子分析归纳出五种膳食模式,未发现HDP组与对照组的膳食模式评分存在统计学差异。结论上海地区妊娠期女性能量、硫胺素及饮料的摄入增加与HDP发病风险正相关,高DASH膳食评分是HDP发病的保护因素。
Objective To investigate the association between dietary factors and risk of hypertensive disorders of pregnancy(HDP).Methods A pregnancy cohort was established at the Obstetrics and Gynecology Hospital affiliated to Fudan University in Shanghai from October 2018 to January 2019.Diet was assessed using 24-hour dietary recall(3-day)during the second trimester of pregnancy.A 1:2 pair-matched case-control study was conducted by selecting 67 pregnant women diagnosed with HDP from the second trimester to childbirth(cases),and pairing them with 134 heathy controls.A priori method(Dietary Approach to Stop Hypertension,DASH diet)and a posteriori method(factor analysis)were applied to identify mid-pregnancy dietary patterns,and conditional logistic regression(CLR)was used to estimate the association between nutrients,food groups,dietary patterns and risk of developing HDP.Results The dietary intakes of energy,protein,total fat,thiamin,zinc,fatty acids,saturated fatty acid(SFA),monounsaturated fatty acid(MUFA)and polyunsaturated fatty acid(PUFA)were significantly higher in HDP cases than in the controls.Multivariate logistic regression analysis showed a significantly positive association between energy intake(OR=18.646,95%CI:4.215,82.490,P<0.001),thiamine(OR=10.738,95%CI:1.853,62.220,P=0.008)and the development of HDP.In terms of food groups,the consumption of meat products and beverages were significantly higher in HDP cases than in the controls,and the consumption of beverages was positively associated with HDP(OR=3.697,95%CI:1.168,11.710,P=0.026).With regard to the priori dietary pattern,no statistically significant difference was found in DASH dietary score between the cases and controls,but the DASH dietary score was negatively associated with HDP(OR=0.149,95%CI:0.030-0.735,P=0.019).In terms of the posteriori dietary patterns,we identified five dietary patterns by factor analysis,but none of their scores differed significantly between the cases and controls.Conclusion For pregnant women in Shanghai,the intakes of dietary energy,thiamine and beverages were positively associated with increased risk of developing HDP,and high DASH dietary score was a protective factor against the risk of HDP.
作者
邓泽群
王娜
李永珍
孙卓
刘雨薇
何更生
DENG Ze-qun;WANG Na;LI Yong-zhen;SUN Zhuo;LIU Yu-wei;HE Geng-sheng(Department of Nutrition and Food Hygiene,College of Public Health,Fudan University,Shanghai 200030;The Obstetrics&Gynecology Hospital of Fudan University,Shanghai 200090,China)
出处
《营养学报》
CAS
CSCD
北大核心
2021年第5期421-429,共9页
Acta Nutrimenta Sinica
基金
国家自然科学基金(No.81773413)
