The Association Between Dietary Choline And Betaine Intake In Mid-pregnancy Women And Gestational Diabetes Mellitus

Objective: To investigate the intake levels of dietary choline and betaine and the incidence of gestational diabetes among pregnant women in wuhan.To explore the association between pregnant women’s dietary choline and betaine intake and gestational diabetes,so as to provide scientific basis for reasonable dietary guidance of pregnant women.Methods: This study used a prospective cohort study design,and pregnant women who were enrolled in the Tongji-Central hospital Maternal and Child Health Cohort of from March 2018 to January 2020 were selected as this study subjects.The food frequency questionnaire(FFQ)after reliability and validity tests was used to investigate the dietary intake of pregnant women.Dietary analysis software was used to calculate energy and nutrient intake,and residual method was used to adjust nutrient intake.GDM is diagnosed according to the diagnostic criteria issued by the international association of diabetes and pregnancy in 2010.According to the average daily intake of choline and betaine in the second trimester,these subjects were divided into five groups,and binary Logistic regression model was used to analyze the association between dietary intake of choline and betaine and the risk of GDM.Results: A total of 1249 pregnant women aged between 19 and 43 years were included in the analysis,184 pregnant women were diagnosed with GDM,with an incidence of 14.7%.In this study,the median of total choline intake in the second trimester was 255.4 mg/d,and the median of betaine intake was 74.2 mg/d.Using binary logistic regression model,and adjusting the confounding factors(the pregnant woman age,BMI before childbirth,family history of diabetes,hypertension,family history,pregnancy after exercise),with the Q2 group as the reference group,the risk of GDM in the Q5 group was 1.71 times that of the Q2 group,and the risk of GDM in the Q3 group was 1.69 times that of the Q2 group.The corresponding Odds ratios(OR)and95% confidence intervals(CIs)were 1.714(1.023,2.872)and 1.690(1.018,2.807)(P for trend > 0.05).Conclusion: The intake level of dietary choline and betaine in pregnant women in wuhan were 255.4(214.5,301.5)mg/d and 74.2(54.8,94.2)mg/d.This study suggests that the high level of dietary choline may be a risk factor for the development of GDM,and no significant correlation between dietary betaine intake and GDM has been found,which needs to be verified by further studies.