High folate and low vitamin B12 status during pregnancy is associated with gestational diabetes mellitus.
High folate and low vitamin B12 status during pregnancy is associated with gestational diabetes mellitus.
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DOI：
10.1016/j.clnu.2017.03.022
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Chong MFF
中科院分区：
文献类型：
--
作者：
Lai JS;Pang WW;Cai S;Lee YS;Chan JKY;Shek LPC;Yap FKP;Tan KH;Godfrey KM;van Dam RM;Chong YS;Chong MFF
B 族维生素和同型半胱氨酸可能会导致妊娠糖尿病 (GDM)，但现有研究并不一致。我们在多种族亚洲孕妇样本中检查了血浆叶酸、维生素 B6、B12 和同型半胱氨酸浓度与 GDM 和血糖的横断面关联。研究人员在 913 名孕妇妊娠 26 周时测量了叶酸、维生素 B6、B12、同型半胱氨酸和葡萄糖的血浆浓度。 GDM的诊断采用1999年世界卫生组织标准。通过线性或逻辑回归检查关联性，调整混杂因素并按种族分层。较高的血浆叶酸与较高的 2 小时血糖和较高的 GDM 几率相关 [叶酸每增加 1-SD 0.15 (0.02, 0.23)，OR 1.29 (1.00, 1.60)]，主要发生在印度母亲中。较高的血浆维生素 B12 和同型半胱氨酸与较低的空腹血糖和 2 小时血糖以及较低的 GDM 几率相关 [B12 每增加 1-SD 分别为 -0.04 (-0.07, -0.01) 和 -0.09 (-0.18, -0.003)，OR：0.81 (0.68, 0.97)；同型半胱氨酸每增加 1-SD，分别为 -0.05 (-0.08，-0.02) 和 -0.12 (-0.21，-0.02)，OR：0.76 (0.62，0.92)]。在维生素 B12 缺乏和叶酸浓度高的女性中观察到 GDM 的几率最高 [OR：1.97 (1.05, 3.68)]。较高的维生素 B6 与较高的 2 小时血糖之间的关联转向对其他 B 族维生素进行零调整。母亲叶酸水平较高且维生素 B12 不足与 GDM 风险较高相关。这一发现对产前补充剂建议具有潜在影响，但需要在未来的研究中得到证实。
B-vitamins and homocysteine may contribute to the development of gestational diabetes mellitus (GDM), but existing studies are inconsistent. We examined the cross-sectional associations of plasma folate, vitamins B6, B12, and homocysteine concentrations with GDM and glycaemia in a sample of multi-ethnic Asian pregnant women. Plasma concentrations of folate, vitamins B6, B12, homocysteine and glucose were measured at 26-weeks’ gestation in 913 pregnant women. GDM was diagnosed using the 1999 World Health Organization criteria. Associations were examined with linear or logistic regression, adjusted for confounders and stratified by ethnicity. Higher plasma folate was associated with higher 2-hour glucose and higher odds of GDM [0.15 (0.02, 0.23) per 1-SD increment in folate, OR 1.29 (1.00, 1.60)], mainly among Indian mothers. Higher plasma vitamin B12 and homocysteine were associated with lower fasting and 2-hour glucose, and lower odds of GDM [-0.04 (-0.07, -0.01) per 1-SD increment in B12 and -0.09 (-0.18, -0.003) respectively, OR: 0.81 (0.68, 0.97); -0.05 (-0.08, -0.02) per 1-SD increment in homocysteine and -0.12 (-0.21, -0.02) respectively, OR: 0.76 (0.62, 0.92)]. The highest odds of GDM were observed among women with combined vitamin B12 insufficiency and high folate concentration [OR: 1.97 (1.05, 3.68)]. An association between higher vitamin B6 and higher 2-hour glucose shifted towards null adjusting for other B-vitamins. Higher maternal folate coupled with vitamin B12 insufficiency was associated with higher GDM risk. This finding has potential implications for antenatal supplement recommendations but will require confirmation in future studies.
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