Association of Maternal Folate and Vitamin B(12) in Early Pregnancy With Gestational Diabetes Mellitus: A Prospective Cohort Study.
Association of Maternal Folate and Vitamin B(12) in Early Pregnancy With Gestational Diabetes Mellitus: A Prospective Cohort Study.
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DOI：
10.2337/dc20-1607
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发表时间：
2021-01
期刊：
影响因子：
16.2
通讯作者：
Yan W
中科院分区：
文献类型：
--
作者：
Chen X;Zhang Y;Chen H;Jiang Y;Wang Y;Wang D;Li M;Dou Y;Sun X;Huang G;Yan W
探讨妊娠早期叶酸和维生素 B12 与妊娠期糖尿病 (GDM) 风险的关系。本研究的数据来自上海孕前队列研究的一个子队列。我们纳入了在招募时（妊娠 9 至 13 周）进行红细胞 (RBC) 叶酸和维生素 B12 测量的妊娠，以及在口服葡萄糖耐量测试下可用于葡萄糖测量的三个样本的妊娠。 GDM 在妊娠 24 至 28 周之间被诊断出来。使用患有 GDM 的比值比 (OR) 和 95% CI 来量化相关性。共纳入1058名孕妇，其中180名（17.01%）发生GDM。患有 GDM 的孕妇的红细胞叶酸和维生素 B12 显着高于无 GDM 的孕妇（P 值分别为 0.045 和 0.002），并且与 1 小时和 2 小时血糖呈正相关。怀孕早期每日补充叶酸会增加妊娠期糖尿病的风险； OR (95% CI) 为 1.73 (1.19–2.53) (P = 0.004)。与红细胞叶酸<400 ng/mL相比，红细胞叶酸≥600 ng/mL的妊娠与GDM的几率高出约1.60倍；调整后的 OR (95% CI) 为 1.58 (1.03–2.41) (P = 0.033)。观察到不同红细胞叶酸类别对 GDM 风险的显着风险影响趋势（Ptrend = 0.021）。维生素 B12 与 GDM 风险显着相关（OR 1.14 每 100 pg/mL；P = 0.002）。未观察到血清叶酸和红细胞叶酸/维生素 B12 百分位比与 GDM 之间存在显着相关性。妊娠早期母亲红细胞叶酸和维生素 B12 水平较高与 GDM 风险显着相关，而叶酸/维生素 B12 平衡与 GDM 没有显着相关。
To investigate the association of folate and vitamin B12 in early pregnancy with gestational diabetes mellitus (GDM) risk. The data of this study were from a subcohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B12 measurements at recruitment (between 9 and 13 gestational weeks) and those with three samples available for glucose measurements under an oral glucose tolerance test. GDM was diagnosed between 24 and 28 weeks’ gestation. Odds ratio (OR) and 95% CI of having GDM was used to quantify the association. A total of 1,058 pregnant women were included, and GDM occurred in 180 (17.01%). RBC folate and vitamin B12 were significantly higher in pregnancies with GDM than those without GDM (P values were 0.045 and 0.002, respectively) and positively correlated with 1-h and 2-h serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM; OR (95% CI) was 1.73 (1.19–2.53) (P = 0.004). Compared with RBC folate <400 ng/mL, pregnancies with RBC folate ≥600 ng/mL were associated with ∼1.60-fold higher odds of GDM; the adjusted OR (95% CI) was 1.58 (1.03–2.41) (P = 0.033). A significant trend of risk effect on GDM risk across categories of RBC folate was observed (Ptrend = 0.021). Vitamin B12 was significantly associated with GDM risk (OR 1.14 per 100 pg/mL; P = 0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B12 with GDM was observed. Higher maternal RBC folate and vitamin B12 levels in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B12 is not significantly associated with GDM.
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