论著 · 公共卫生

n⁃3多不饱和脂肪酸、汞与妊娠期糖尿病的关联

  • 杨科峰 ,
  • 贾洁 ,
  • 丁天泽 ,
  • 张硕 ,
  • 李心怡 ,
  • 祝捷 ,
  • 刘玉红 ,
  • 卢凌鹏 ,
  • 吴慧
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  • 1.上海交通大学医学院附属新华医院临床营养科,上海 200092
    2.上海交通大学医学院医学技术学院临床营养系,上海 200025
    3.上海市小儿消化与营养重点实验室,上海 200092
    4.School of Family and Consumer Sciences,Texas State University,San Marcos 78666
    5.上海中医药大学附属第七人民医院妇产科,上海 200137
    6.上海中医药大学附属第七人民医院检验科,上海 200137
    7.上海中医药大学附属第七人民医院营养科,上海 200137
杨科峰(1973—),男,讲师,博士;电子信箱:yangkf@sjtu.edu.cn
贾 洁 (1980—),女,副研究员,博士;电子信箱:jie.jia@shsmu.edu.cn。第一联系人:*为共同第一作者。
吴 慧,电子信箱:877761520@qq.com
卢凌鹏,电子信箱:llpeng2012@163.com

收稿日期: 2022-06-24

  录用日期: 2022-09-04

  网络出版日期: 2022-10-12

基金资助

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)

Association of n-3 polyunsaturated fatty acids and mercury during pregnancy with gestational diabetes mellitus

  • Kefeng YANG ,
  • Jie JIA ,
  • Tianze DING ,
  • Shuo ZHANG ,
  • Xinyi LI ,
  • Jie ZHU ,
  • Yuhong LIU ,
  • Lingpeng LU ,
  • Hui WU
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  • 1.Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
    2.Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    3.Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China
    4.School of Family and Consumer Sciences, Texas State University, San Marcos 78666, USA
    5.Department of Obstetrics and Gynecology, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
    6.Department of Clinical Laboratory, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
    7.Department of Nutrition, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
WU Hui, E-mail: 877761520@qq.com.
LU lingpeng, E-mail: llpeng2012@163.com

Received date: 2022-06-24

  Accepted date: 2022-09-04

  Online published: 2022-10-12

Supported by

National Natural Science Foundation of China(81573140);Undergraduate Innovation Program of Shanghai Jiao Tong University School of Medicine(1521Z401);Research Project of Shanghai University of Traditional Chinese Medicine(2019LK042)

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0.31 μg/L,GDM孕妇血清汞均值为0.29 μg/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。

本文引用格式

杨科峰 , 贾洁 , 丁天泽 , 张硕 , 李心怡 , 祝捷 , 刘玉红 , 卢凌鹏 , 吴慧 . n⁃3多不饱和脂肪酸、汞与妊娠期糖尿病的关联[J]. 上海交通大学学报(医学版), 2022 , 42(12) : 1739 -1744 . DOI: 10.3969/j.issn.1674-8115.2022.12.012

Abstract

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.

参考文献

1 杨雅, 赵梅. 膳食脂肪酸与妊娠期糖尿病关系的研究进展[J]. 中国食物与营养, 2020, 26(9): 61-65.
1 YANG Y,ZHAO M. The relationship between dietary fatty acids and gestational diabetes mellitus[J]. Food Nutr China, 2020, 26(9): 61-65.
2 GAO C H, SUN X, LU L, et al. Prevalence of gestational diabetes mellitus in mainland China: a systematic review and meta-analysis[J]. J Diabetes Investig, 2019, 10(1): 154-162.
3 KIM C, NEWTON K M, KNOPP R H. Gestational diabetes and the incidence of type 2 diabetes: a systematic review[J]. Diabetes Care, 2002, 25(10): 1862-1868.
4 MIJATOVIC-VUKAS J, CAPLING L, CHENG S, et al. Associations of diet and physical activity with risk for gestational diabetes mellitus: a systematic review and meta-analysis[J]. Nutrients, 2018, 10(6): 698.
5 MAHJOUB F, BEN JEMAA H, BEN SABEH F, et al. Impact of nutrients and Mediterranean diet on the occurrence of gestational diabetes[J]. Libyan J Med, 2021, 16(1): 1930346.
6 RAGHAVAN R, DREIBELBIS C, KINGSHIPP B L, et al. Dietary patterns before and during pregnancy and maternal outcomes: a systematic review[J]. Am J Clin Nutr, 2019, 109(Suppl 7): 705S-728S.
7 ZHOU S J, YELLAND L, MCPHEE A J, et al. Fish-oil supplementation in pregnancy does not reduce the risk of gestational diabetes or preeclampsia[J]. Am J Clin Nutr, 2012, 95(6): 1378-1384.
8 JAMILIAN M, SAMIMI M, MIRHOSSEINI N, et al. A randomized double-blinded, placebo-controlled trial investigating the effect of fish oil supplementation on gene expression related to insulin action, blood lipids, and inflammation in gestational diabetes mellitus-fish oil supplementation and gestational diabetes[J]. Nutrients, 2018, 10(2): 163.
9 PENG S Y, LIU L P, ZHANG X Q, et al. A nested case-control study indicating heavy metal residues in meconium associate with maternal gestational diabetes mellitus risk[J]. Environ Health, 2015, 14: 19.
10 SOOMRO M H, BAIZ N, HUEL G, et al. Exposure to heavy metals during pregnancy related to gestational diabetes mellitus in diabetes-free mothers[J]. Sci Total Environ, 2019, 656: 870-876.
11 WANG Y, ZHANG P, CHEN X, et al. Multiple metal concentrations and gestational diabetes mellitus in Taiyuan, China[J]. Chemosphere, 2019, 237: 124412.
12 SACKS D A, HADDEN D R, MARESH M, et al. Frequency of gestational diabetes mellitus at collaborating centers based on IADPSG consensus panel-recommended criteria: the hyperglycemia and adverse pregnancy outcome (HAPO) study[J]. Diabetes Care, 2012, 35(3): 526-528.
13 王蓓, 沈丽蔚, 周丽莉, 等. 孕期胆碱摄入及母婴体内胆碱代谢水平的相关性[J]. 中华围产医学杂志, 2017, 20(11): 790-795.
13 WANG B, SHEN L W, ZHOU L L, et al. Association between choline intake during pregnancy and choline metabolism in parturients and infants[J]. Chin J Perinat Med, 2017, 20(11): 790-795.
14 杨月欣. 中国食物成分表(标准版): 第2册[M]. 6版. 北京: 北京大学医学出版社, 2019: 290-309.
14 YANG Y X. China food composition tables (standard edition): volume 2[M]. 6th ed. Beijing: Peking University Medical Press, 2019: 290-309.
15 NIJS H, BENHALIMA K. Gestational diabetes mellitus and the long-term risk for glucose intolerance and overweight in the offspring: a narrative review[J]. J Clin Med, 2020, 9(2): 599.
16 GáZQUEZ A, GIMéNEZ-BA?óN M J, PRIETO-SáNCHEZ M T, et al. Self-reported DHA supplementation during pregnancy and its association with obesity or gestational diabetes in relation to DHA concentration in cord and maternal plasma: results from NELA, a prospective mother-offspring cohort[J]. Nutrients, 2021, 13(3): 843.
17 TRYGGVADOTTIR E A, GUNNARSDOTTIR I, BIRGISDOTTIR B E, et al. Early pregnancy plasma fatty acid profiles of women later diagnosed with gestational diabetes[J]. BMJ Open Diabetes Res Care, 2021, 9(1): e002326.
18 OGUNDIPE E, SAMUELSON S, CRAWFORD M A. Gestational diabetes mellitus prediction? A unique fatty acid profile study[J]. Nutr Diabetes, 2020, 10(1): 36.
19 RADESKY J S, OKEN E, RIFAS-SHIMAN S L, et al. Diet during early pregnancy and development of gestational diabetes[J]. Paediatr Perinat Epidemiol, 2008, 22(1): 47-59.
20 SAMIMI M, JAMILIAN M, ASEMI Z, et al. Effects of omega-3 fatty acid supplementation on insulin metabolism and lipid profiles in gestational diabetes: randomized, double-blind, placebo-controlled trial[J]. Clin Nutr, 2015, 34(3): 388-393.
21 ONAT T, DEMIR CALTEKIN M, TURKSOY V A, et al. The relationship between heavy metal exposure, trace element level, and monocyte to HDL cholesterol ratio with gestational diabetes mellitus[J]. Biol Trace Elem Res, 2021, 199(4): 1306-1315.
22 SHAPIRO G D, DODDS L, ARBUCKLE T E, et al. Exposure to phthalates, bisphenol A and metals in pregnancy and the association with impaired glucose tolerance and gestational diabetes mellitus: the MIREC study[J]. Environ Int, 2015, 83: 63-71.
23 VIRTANEN J K, MURSU J, VOUTILAINEN S, et al. Serum omega-3 polyunsaturated fatty acids and risk of incident type 2 diabetes in men: the Kuopio Ischemic Heart Disease Risk Factor study[J]. Diabetes Care, 2014, 37(1): 189-196.
24 D'ASCOLI T A, MURSU J, VOUTILAINEN S, et al. Association between serum long-chain omega-3 polyunsaturated fatty acids and cognitive performance in elderly men and women: the kuopio ischaemic heart disease risk factor study[J]. Eur J Clin Nutr, 2016, 70(8): 970-975.
25 TAJIK B, KURL S, TUOMAINEN T P, et al. Associations of the serum long-chain n-3 PUFA and hair mercury with resting heart rate, peak heart rate during exercise and heart rate recovery after exercise in middle-aged men[J]. Br J Nutr, 2018, 119(1): 66-73.
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