Study On Dietary Factors Related To Gestational Diabetes Mellitus Based On Network Analysis

Objective: Gestational diabetes mellitus is a serious disease which seriously affects maternal and infant health.It is characterized by abnormal glucose tolerance first detected or developed during pregnancy.Its pathophysiology has not been fully elucidated.The risk of gestational diabetes is related to age,body mass index,assisted reproduction,family history of diabetes,diet and other factors.In this study,dietary data related to gestational diabetes mellitus and dietary differences were mined and the relationship between dietary intake and gestational diabetes mellitus was studied through network analysis based on the birth cohort which is the subcohort of Northeast China cohort.Methods: This study was carried out based on the Northeast China cohort.Pregnant women at 23 to 29 weeks of gestation were included,and patients with diabetes combined with pregnancy or history of gestational diabetes were excluded.Data was collected by questionnaire survey,physical examination,laboratory biochemical examination and other methods.Biochemical tests in the laboratory included measuring fasting blood suger levels,one hour after a meal,and two hours after.The questionnaire’s contents were organized and inputted,thus creating a queue database.Food frequency questionnaire was employed to acquire dietary information.Estimate the amount of food consumed in accordance with the pre-set portion size and frequency.The subjects were divided into gestational diabetes mellitus group and control group.Baseline information and dietary intake of the subjects were counted.And t test was conducted for continuous variables and Chi-square test for categorical variables.R minet program package was used to calculate the mutual information value of food item intake,construct the mutual information matrix,and generate the weighted adjacency matrix of the network.Converts the matrix to a network file in edge-list form,then input into Cytoscape,plot the network,and analyze network differences by comparing network node point degree centrality,proximity centrality,intermediary centrality index,and node association strength.Results: A total of 2516 participants were included in the birth cohort,and 2364 participants were included after excluding patients with diabetes and a history of gestational diabetes,of which 503 had gestational diabetes.There were statistically significant differences in age,assisted reproduction conception,pre-pregnancy body mass index and family history of diabetes between the case and control groups(P<0.01).Before pregnancy,there were statistically significant differences in the intake of multi-grain,cheese,yogurt,fried egg or scrambled egg,eggplant,broccoli,carrot,red date,banana,sauerkraut,western dessert or cake,Chinese dim sum,biscuits,honey and black tea(P<0.05).The mean intakes of sauerkraut and black tea were higher in gestational diabetes group,while the mean intakes of other food items were higher in control group.There were statistically significant differences in food intake of rice,milk,cheese,yogurt,boiled egg,fried egg or scrambled egg,eggplant,red dates,banana,watermelon,peach,grape,pastry or cake,Chinese dim sum,preserved fruit and jam,ice cream and honey,during the second trimester(P<0.05).The mean intakes of milk and boiled egg in the gestational diabetes group were larger,while the mean intakes of other food items in the control group were larger.The dietary pattern of subjects was mainly rice and porridge,combined with fruit and vegetable intake.The key node of the gestational non-diabetes group was vegetable food,and the key node of gestational diabetes group was fruit food.The top 5 nodes in the absolute value of network difference between the two groups before pregnancy were pear,banana,orange,leek and apple.In the second trimester,the top 5nodes were bananas,other kinds of fruit,apple,carrot and kiwi fruit.Conclusion: The diet of the population included in this study was mainly plant foods before and during pregnancy,and the main dietary intake categories included staple foods represented by rice and porridge,fruits and vegetables.And with dairy products,beans,livestock meat,eggs and aquatic products.The gestational diabetes group was more inclined to eat fruits,while the control group was more inclined to eat vegetables in combination.Fruit preferences may be linked to gestational diabetes.Dietary preferences of vegetables and fruits may be important dietary factors affecting gestational diabetes,and differences in dietary networks between different populations can be used to infer dietary preferences.This study provides a reference for dietary intervention methods for gestational diabetes..