摘要
目的·通过了解上海地区孕妇n-3多不饱和脂肪酸(n-3 polyunsaturated fatty acid,n-3 PUFA),包括二十碳五烯酸(eicosapentaenoic acid,EPA)、二十二碳六烯酸(docosahexaenoic acid,DHA)摄入情况以及血清汞水平,分析n-3 PUFA摄入以及汞暴露是否为妊娠期糖尿病(gestational diabetes mellitus,GDM)发病的危险因素。方法·纳入2018年1月—2021年1月于上海中医药大学附属第七人民医院产科建卡的孕妇进行了膳食调查、临床数据收集、血清样本采集和检测。于孕24±1周采用半定量食物频率法对入组孕妇进行膳食及营养素补充剂调查,根据对照组n-3 PUFA摄入量(膳食摄入DHA、膳食摄入EPA、DHA补充剂)以及血清汞进行三分位数分组后,用Logistic回归分别计算其与GDM发生风险的OR值及95%可信区间,并校正其他已知的GDM危险因素(BMI、年龄、糖尿病家族史、能量)。采用偏相关统计膳食DHA、膳食EPA与血清汞的相关性。结果·519名孕妇中对照组孕妇361名,GDM孕妇158名。对照组孕妇膳食DHA摄入量均值为29.78 mg/d、膳食EPA摄入量均值为23.90 mg/d,GDM孕妇膳食DHA摄入量均值为37.47 mg/d、膳食EPA摄入量均值为28.94 mg/d,均远低于中国营养学会推荐的适宜摄入量。对照组孕妇血清汞均值为0.31μg/L,GDM孕妇血清汞均值为0.29μg/L。在校正其他危险因素后,Logistic回归分析显示膳食DHA摄入量(P trend=0.135)、膳食+补充剂DHA (P trend=0.371)、EPA摄入量(P trend=0.106)、n-3 PUFA膳食摄入量(P trend=0.382)以及血清汞(P trend=0.514)与GDM没有显著相关性;偏相关统计发现膳食DHA、膳食EPA与孕妇血清汞没有明显相关性(P=0.126,P=0.543)。结论·较低水平的n-3 PUFA摄入以及汞暴露与GDM没有相关性。
Objective·To investigate the dietary intake of n-3 polyunsaturated fatty acids(n-3 PUFA), including eicosapentaenoic acid(EPA) and docosahexaenoic acid(DHA), and serum mercury levels in the pregnant women in Shanghai, and analyze whether n-3 polyunsaturated fatty acids intake and mercury exposure are risk factors of GDM. Methods·From January 2018 to January 2021,dietary survey, clinical data collection, and serum samples collection and testing were conducted among the pregnant women who sought prenatal care in Shanghai Seventh People’s Hospital, Shanghai University of Traditional Chinese Medicine. Dietary and dietary supplements were investigated by semi-quantitative food frequency questionnaire at 24±1 gestational week. The n-3 PUFA intake(dietary DHA and EPA, and DHA supplements) and serum mercury in control group were divided into tertiles. After adjusting the other known risk factors for GDM(BMI, age, family history of diabetes, and energy), the odds ratios and 95% confidence intervals of the risk of GDM were calculated by Logistic regression. Partial correlation analysis was used to analyze the correlation between dietary DHA or EPA and serum mercury. Results·Among 519 pregnant women, there were 361 normal pregnant women and 158 pregnant women with GDM. The average intakes of DHA and EPA in the normal pregnant women were 29.78 mg/d and 23.90 mg/d,respectively and the average intakes of DHA and EPA in the pregnant women with GDM were 37.47 mg/d and 28.94 mg/d,respectively. All of them were far below the appropriate intake recommended by the Chinese Nutrition Society. The mean value of serum mercury was 0.31 μg/L in the normal pregnant women and 0.29 μg/L in the pregnant women with GDM. After adjusting the other risk factors, multivariate Logistic regression analysis showed that dietary DHA intake(P trend=0.135), dietary + supplement DHA(P trend=0.371), EPA intake(P trend=0.106), dietary intake of n-3 PUFA(P trend=0.382) and serum mercury(P trend=0.514)were not significantly correlated with GDM. The partial correlation analysis found that dietary DHA and dietary EPA were not significantly correlated with serum mercury in the pregnant women(P=0.126, P=0.543). Conclusion·Low level of n-3 PUFA intake and mercury exposure are not associated with GDM.
作者
杨科峰
贾洁
丁天泽
张硕
李心怡
祝捷
刘玉红
卢凌鹏
吴慧
YANG Kefeng;JIA Jie;DING Tianze;ZHANG Shuo;LI Xinyi;ZHU Jie;LIU Yuhong;LU Lingpeng;WU Hui(Department of Clinical Nutrition,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Clinical Nutrition,College of Health Science and Technology,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition,Shanghai 200092,China;School of Family and Consumer Sciences,Texas State University,San Marcos 78666,USA;Department of Obstetrics and Gynecology,Shanghai Seventh People's Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Department of Clinical Laboratory,Shanghai Seventh People's Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Department of Nutrition,Shanghai Seventh People's Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2022年第12期1739-1744,共6页
Journal of Shanghai Jiao tong University:Medical Science
基金
国家自然科学基金(81573140)
上海交通大学医学院大学生创新训练计划(1521Z401)
上海中医药大学校级课题(2019LK042)。
关键词
N-3多不饱和脂肪酸
二十碳五烯酸
二十二碳六烯酸
血清汞
妊娠期糖尿病
n-3 polyunsaturated fatty acid(n-3 PUFA)
eicosapentaenoic acid(EPA)
docosahexaenoic acid(DHA)
serum mercury
gestational diabetes mellitus(GDM)
