Abstract
BackgroundAn increasing body of evidence suggests that cholesterol intake increases during pregnancy and may influence the risk of gestational diabetes mellitus (GDM). However, existing evidence remains controversial and limited. The present study aimed to determine the relation among dietary cholesterol, specifically egg consumption, in pregnant Chinese women and their risk of GDM.MethodsA population-based study that included 1617 pregnant women was conducted in 2017. At baseline, dietary information was collected by 24-hour dietary recalls over three days. GDM was diagnosed by a 75 g 2-hr oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. Logistic regression models were used to examine the associations of dietary cholesterol and egg intake with GDM. In addition, path analysis including cholesterol intake, plasma lipid profiles and GDM risk was conducted.ResultsThe average total cholesterol intake was 340.8 mg/d, and cholesterol from eggs accounted for 59.2%. The odds ratio (OR) of GDM risk was 1.48 for the highest quartile of total cholesterol intake compared to the lowest quartile (95% CI 1.10-2.00; Ptrend = 0.015) after adjustment for potential risk factors for GDM. Moreover, cholesterol from eggs rather than from other foods was positively associated with incident GDM (OR=1.09, 95% CI 1.03-1.17). Each additional egg consumed per day was positively correlated with a higher risk of GDM (OR=1.32, 95% CI 1.11-1.58). Path analysis indicated that cholesterol intake not only increased the risk of GDM by elevating plasma total cholesterol (TC), but also increased the risk of GDM through other non hyperlipidemia pathways.ConclusionsMaternal dietary cholesterol intake was significantly associated with incident GDM, and egg consumption was a major driver of the association in this population. More studies are needed to substantiate these findings and to explore the underlying mechanisms.
Highlights
An increasing body of evidence suggests that cholesterol intake increases during pregnancy and may influence the risk of gestational diabetes mellitus (GDM)
Associations between maternal cholesterol intake and GDM After adjusting for potential confounders, each additional 100 mg/d of total dietary cholesterol was significantly and positively associated with a higher risk of GDM (OR=1.07, 95% Confidence intervals (CI) 1.02-1.13; Table 2)
The odds ratio (OR) for GDM were 1.39, 1.40 and 1.55 for successive quartiles of total cholesterol intake (P trend=0.015) compared to the lowest quartile (Table 2)
Summary
An increasing body of evidence suggests that cholesterol intake increases during pregnancy and may influence the risk of gestational diabetes mellitus (GDM). The present study aimed to determine the relation among dietary cholesterol, egg consumption, in pregnant Chinese women and their risk of GDM. One survey in China showed that pregnant women’s dietary cholesterol intake could reach 379 mg/d [8]. Previous studies have indicated that dietary cholesterol increases the risk of GDM [9, 10], and a meta-analysis of five longitudinal studies has shown that high cholesterol intake is positively associated with the risk of developing T2DM [11]. To the best of our knowledge, no studies investigating the impact of dietary cholesterol on pregnant women have been reported in Southwest China
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