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

doi:10.3969/j.issn.1674-8115.2022.12.012

Abstract

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.

Key words: n-3 polyunsaturated fatty acid (n-3 PUFA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), serum mercury, gestational diabetes mellitus (GDM)

CLC Number:

R151.4

YANG Kefeng, JIA Jie, DING Tianze, ZHANG Shuo, LI Xinyi, ZHU Jie, LIU Yuhong, LU Lingpeng, WU Hui. Association of n-3 polyunsaturated fatty acids and mercury during pregnancy with gestational diabetes mellitus[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(12): 1739-1744.

Figures/Tables 3

TrendMD

References 25

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Indicator	Control （n=361）	GDM （n=158）	P value
Age/year	28.36±4.54	30.73±4.62	0.000
Education level/n （%）			0.801
Below college	289 （80.1）	128 （81.0）
College and above	72 （19.9）	30 （19.0）
Parity/n （%）			0.017
primiparity	193 （53.5）	66 （41.8）
multipara	168 （46.5）	92 （58.2）
Family history of diabetes/n （%）			0.000
Yes	47 （13.0）	38 （24.1）
No	314 （87.0）	120 （75.9）
BMI before pregnancy/n （%）			0.000
<18.5 kg·m^-2	47 （13.0）	12 （7.6）
18.5‒23.9 kg·m^-2	222 （61.5）	75 （47.5）
≥24.0 kg·m^-2	92 （25.5）	71 （44.9）
DHA supplement/n （%）			0.189
Yes	111 （30.7）	58 （36.7）
No	250 （69.3）	100 （63.3）
Dose of DHA supplement/（mg·d^-1）^①	290.53±124.80	328.11±157.36	0.155
Dietary DHA/（mg·d^-1）	29.78 （5.62， 38.67）	37.47 （7.31， 48.47）	0.080
Dietary EPA/（mg·d^-1）	23.90 （5.55， 28.97）	28.94 （6.98， 39.44）	0.134
Dietary n-3 PUFA/（mg·d^-1）	53.68 （11.60， 67.82）	66.41 （14.46， 88.48）	0.097
Serum mercury/（μg·L^-1）	0.31 （0.07， 0.56）	0.29 （0.11， 0.43）	0.262
Energy/（kcal·d^-1）^②	1 682.30±441.07	1 731.25±526.81	0.398

Indicator	Control （n=361）	GDM （n=158）	P value
Age/year	28.36±4.54	30.73±4.62	0.000
Education level/n （%）			0.801
Below college	289 （80.1）	128 （81.0）
College and above	72 （19.9）	30 （19.0）
Parity/n （%）			0.017
primiparity	193 （53.5）	66 （41.8）
multipara	168 （46.5）	92 （58.2）
Family history of diabetes/n （%）			0.000
Yes	47 （13.0）	38 （24.1）
No	314 （87.0）	120 （75.9）
BMI before pregnancy/n （%）			0.000
<18.5 kg·m^-2	47 （13.0）	12 （7.6）
18.5‒23.9 kg·m^-2	222 （61.5）	75 （47.5）
≥24.0 kg·m^-2	92 （25.5）	71 （44.9）
DHA supplement/n （%）			0.189
Yes	111 （30.7）	58 （36.7）
No	250 （69.3）	100 （63.3）
Dose of DHA supplement/（mg·d^-1）^①	290.53±124.80	328.11±157.36	0.155
Dietary DHA/（mg·d^-1）	29.78 （5.62， 38.67）	37.47 （7.31， 48.47）	0.080
Dietary EPA/（mg·d^-1）	23.90 （5.55， 28.97）	28.94 （6.98， 39.44）	0.134
Dietary n-3 PUFA/（mg·d^-1）	53.68 （11.60， 67.82）	66.41 （14.46， 88.48）	0.097
Serum mercury/（μg·L^-1）	0.31 （0.07， 0.56）	0.29 （0.11， 0.43）	0.262
Energy/（kcal·d^-1）^②	1 682.30±441.07	1 731.25±526.81	0.398

Indicator	Group			Crude OR （95% CI）	P trend	Adjusted OR （95% CI）^①	P trend
Indicator	Control/n		GDM/n	Crude OR （95% CI）	P trend	Adjusted OR （95% CI）^①	P trend
Dietary DHA/（mg·d^-1）					0.311		0.135
≤10.26	121	50		1 （ref）		1 （ref）
10.27‒28.06	120	45		0.89 （0.56，1.44）		0.70 （0.34，1.46）
≥28.07	120	63		1.26 （0.80，1.98）		1.47 （0.73，2.94）
Dietary DHA+DHA supplement/（mg·d^-1）					0.313		0.371
≤17.63	121	50		1 （ref）		1 （ref）
17.64‒88.27	120	42		0.89 （0.56，1.44）		0.95 （0.58，1.57）
≥88.28	120	66		1.26 （0.80，1.98）		1.31 （0.81，2.10）
Dietary EPA/（mg·d^-1）					0.118		0.106
≤9.30	121	51		1 （ref）		1 （ref）
9.31‒22.84	120	40		0.80 （0.49， 1.30）		0.57 （0.28， 1.17）
≥22.85	120	67		1.31 （0.84， 2.05）		1.23 （0.61， 2.48）
Dietary n-3 PUFA/（mg·d^-1）					0.923		0.382
≤13.65	121	53		1 （ref）		1 （ref）
13.66‒37.75	120	50		0.95 （0.60， 1.51）		0.61 （0.30， 1.23）
≥37.76	120	55		1.05 （0.67， 1.65）		0.74 （0.37， 1.50）
Serum mercury/（μg·L^-1）					0.492		0.514
≤0.08	121	60		1 （ref）		1 （ref）
0.09‒0.28	120	47		0.77 （0.41， 1.54）		0.86 （0.57， 1.93）
≥0.29	120	51		0.89 （0.72， 2.08）		0.97 （0.88，1.76）

Indicator	Group			Crude OR （95% CI）	P trend	Adjusted OR （95% CI）^①	P trend
Indicator	Control/n		GDM/n	Crude OR （95% CI）	P trend	Adjusted OR （95% CI）^①	P trend
Dietary DHA/（mg·d^-1）					0.311		0.135
≤10.26	121	50		1 （ref）		1 （ref）
10.27‒28.06	120	45		0.89 （0.56，1.44）		0.70 （0.34，1.46）
≥28.07	120	63		1.26 （0.80，1.98）		1.47 （0.73，2.94）
Dietary DHA+DHA supplement/（mg·d^-1）					0.313		0.371
≤17.63	121	50		1 （ref）		1 （ref）
17.64‒88.27	120	42		0.89 （0.56，1.44）		0.95 （0.58，1.57）
≥88.28	120	66		1.26 （0.80，1.98）		1.31 （0.81，2.10）
Dietary EPA/（mg·d^-1）					0.118		0.106
≤9.30	121	51		1 （ref）		1 （ref）
9.31‒22.84	120	40		0.80 （0.49， 1.30）		0.57 （0.28， 1.17）
≥22.85	120	67		1.31 （0.84， 2.05）		1.23 （0.61， 2.48）
Dietary n-3 PUFA/（mg·d^-1）					0.923		0.382
≤13.65	121	53		1 （ref）		1 （ref）
13.66‒37.75	120	50		0.95 （0.60， 1.51）		0.61 （0.30， 1.23）
≥37.76	120	55		1.05 （0.67， 1.65）		0.74 （0.37， 1.50）
Serum mercury/（μg·L^-1）					0.492		0.514
≤0.08	121	60		1 （ref）		1 （ref）
0.09‒0.28	120	47		0.77 （0.41， 1.54）		0.86 （0.57， 1.93）
≥0.29	120	51		0.89 （0.72， 2.08）		0.97 （0.88，1.76）

	Serum mercury^①
	Partial correlation coefficient	P value
Dietary DHA	0.067	0.126
Dietary EPA	0.025	0.543