Low Carbohydrate-Diet Scores and Long-term Risk of Type 2 Diabetes Among Women With a History of Gestational Diabetes Mellitus: A Prospective Cohort Study
Low Carbohydrate-Diet Scores and Long-term Risk of Type 2 Diabetes Among Women With a History of Gestational Diabetes Mellitus: A Prospective Cohort Study
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DOI：
10.2337/dc15-1642
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发表时间：
2016-01-01
期刊：
影响因子：
16.2
通讯作者：
Zhang, Cuilin
中科院分区：
文献类型：
--
作者：
Bao, Wei;Li, Shanshan;Zhang, Cuilin
低碳水化合物饮食（LCD）可以改善妊娠期糖尿病（GDM）患者的短期血糖控制，但对GDM进展为2型糖尿病（T2 DM）的长期影响尚不清楚。我们的目的是检查T2 DM的长期风险与低碳水化合物饮食模式的妇女与GDM.RESEARCH设计和METHODSOverall，4,502名妇女与GDM的历史从护士健康研究II（NHSII）队列，作为糖尿病和妇女健康（DWH）研究的一部分，从1991年至2011年进行了随访。总的来说，动物或蔬菜LCD评分代表了对不同低碳水化合物饮食模式的坚持，使用自1991年以来每4年通过经验证的食物频率问卷评估的饮食摄入信息计算。我们使用考克斯比例风险模型来估计风险比（HR）和95% CI。T2 DM的多变量校正HR（95% CI）（比较最高和最低五分位数）为1.36（1.04-1.78）LCD总分（趋势P = 0.003），1.40（1.06-1.84）动物LCD评分（趋势P = 0.004）和1.19（0.91-1.55）蔬菜LCD评分（趋势P = 0.50）。结论在有GDM病史的妇女中，低碳水化合物饮食模式，特别是主要从动物源性食物中摄入高蛋白质和脂肪，与较高的T2 DM风险相关，而从植物源性食物中摄入高蛋白质和脂肪的低碳水化合物饮食模式与T2 DM风险无显著相关性。
OBJECTIVELow-carbohydrate diets (LCDs) may improve short-term glycemic control in patients with gestational diabetes mellitus (GDM), but the long-term effect on progression from GDM to type 2 diabetes mellitus (T2DM) is unknown. We aimed to examine the long-term risk of T2DM in association with a low-carbohydrate dietary pattern among women with a history of GDM.RESEARCH DESIGN AND METHODSOverall, 4,502 women with a history of GDM from the Nurses' Health Study II (NHSII) cohort, as part of the Diabetes & Women's Health (DWH) study, were followed up from 1991 to 2011. Overall, animal, or vegetable LCD scores, which represent adherence to different low-carbohydrate dietary patterns, were calculated using diet intake information assessed every 4 years since 1991 by validated food-frequency questionnaires. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs.RESULTSWe documented 722 incident cases of T2DM during 68,897 person-years of observation. The multivariable-adjusted HRs (95% CIs) of T2DM, comparing the highest with lowest quintiles, were 1.36 (1.04-1.78) for overall LCD score (P = 0.003 for trend), 1.40 (1.06-1.84) for animal LCD score (P = 0.004 for trend), and 1.19 (0.91-1.55) for vegetable LCD score (P = 0.50 for trend).CONCLUSIONSAmong women with a history of GDM, a low-carbohydrate dietary pattern, particularly with high protein and fat intake mainly from animal-source foods, is associated with higher T2DM risk, whereas a low-carbohydrate dietary pattern with high protein and fat intake from plant-source foods is not significantly associated with risk of T2DM.