Relationship Between Phytosterol Intake And Diabetes Mellitus During First And Second Trimester Of Pregnancy

Objective:To investigate the dietary intake of phytosterols in pregnant women from Northeast China before and during the second trimester.To explore the association between the intake of β-sitosterol,campesterol,stigmasterol,β-sitosterol,campesterol,total sterols and phytosterol-containing foods in pregnant women before and during the second trimester of pregnancy and Gestational Diabetes Mellitus(GDM),and to provide reference and reasonable dietary guidance for the recommended intake of different types and food sources containing phytosterols in pregnant women before and during the second trimester.Methods: The study was cross sectional in design.Subjects were obtained from pregnant women undergoing 75 g Oral Glucose Tolerance Test(OGTT)at Sheng Jing Hospital of China Medical University beginning at the end of the year 2018.Baseline study information was obtained by questionnaire survey,physical exam,and laboratory examination.Food intake was collected using a validated semi-quantitative Food Frequency Questionnaire(FFQ)with characteristics from Northeast China including prepreg Nancy and mid pregnancy.As defined by: The food items containing phytosterols in the questionnaire included grains and their products,fresh vegetables,pulses and their products,and fresh fruit and snacks.The t test,chi square test,rank sum test,and other methods were used to compare and analyze differences in baseline characteristics between the GDM and non-GDM groups.Multivariate logistic regression model was used to analyze the association between the intake of β-sitosterol,campesterol,stigmasterol,β-sitosterol,campesterol total sterols and phytosterol-containing foods and gestational diabetes mellitus.Subgroup analyses were performed using age,prepregnancy BMI,primiparity,and history of miscarriage as stratifying factors,and the interaction between the stratifying factors and the exposure factors was also observed.Results:Ultimately,a total of 2373 subjects were enrolled in the present study,and 571 of them had GDM,with a prevalence rate of 21.79%.Age,pre-pregnancy Body Mass Index(BMI),primiparity,and history of abortion were significantly different between GDM and non-GDM groups(P<0.05).There were significant differences in the levels of carbohydrate,cereal,and fruit intake between the two groups during the second trimester(P < 0.05).There was no significant difference in the intake levels of β-sitosterol,campesterol,stigmasterol,β-sitosterol,campesterol and total sterols between GDM group and non-GDM group.Using the first tertile(T1)of phytosterols intake before and during the second trimester as the reference group,there were no statistically significant associations between the various phytosterols,total sterols and sterol-containing foods before and during the first and second trimester of pregnancy and GDM in the regression analysis of the three models.Because age,BMI before pregnancy,primiparity,and miscarriage history were significantly different between groups in this study,they were used as the stratification basis for subgroup analysis of the association between total phytosterols intake and GDM.Subgroup analysis showed that,compared to the baseline(T1)group,the second(T2)and third(T3)of total phytosterols intake before and during the second trimester were not statistically associated with the risk of GDM in each subgroup.Conclusion:There was no significant association between dietary intake of phytosterols,total sterols and phytosterol-containing foods before and during the second trimester and GDM among pregnant women in Northeast China.Due to the influence of the population surveyed,further studies are required to explore the correlation between them in more depth.