{"title":"母亲胰岛素血症和炎症饮食模式与儿童神经发育迟缓的风险。","authors":"Haixia Wang, Ping Zu, Wanjun Yin, Lei Zhang, Liang Ruan, Xianxia Chen, Peng Zhu","doi":"10.1007/s00394-024-03531-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Our aim was to assess the risk of higher insulinemic, inflammatory, and hyperglycemia potential in the diet during pregnancy with child neurodevelopmental delay.</p><p><strong>Methods: </strong>We enrolled 7,438 pregnant women participating in a prospective cohort study. The food frequency questionnaire was used to evaluate the empirical dietary index for hyperinsulinemia (EDIH), empirical dietary inflammatory pattern (EDIP), glycemic index (GI), and glycemic load (GL) during mid-pregnancy. Child neurodevelopmental assessment was conducted at 6-36 months postpartum using the Denver Developmental Screening Test-II (DDST-II) scale, and the Gesell Developmental Diagnosis Scale (GDDS) was administered to assess children who did not meet the criteria for passing the DDST-II screening.</p><p><strong>Results: </strong>We documented 540 incident child neurodevelopmental delay cases over 7,438 pregnant women (median follow-up: 2 years). Pregnant women exhibiting the high levels of hyperinsulinemic or proinflammatory components, or GI encountered an elevated risk of child neurodevelopmental delay; HRs (95% CI) comparing highest to lowest dietary index quintiles were EDIH 1.48 (1.07,2.04; P <sub>trend</sub> = 0.017), EDIP 1.39 (1.05,1.84; P <sub>trend</sub> = 0.019) and GI 1.36 (1.02,1.81; P <sub>trend</sub> = 0.038). In sex-stratified analyses, these results remained significant only in boys (P <sub>trend</sub> = 0.018 for EDIH, P <sub>trend</sub> = 0.028 for EDIP, P <sub>trend</sub> = 0.029 for GI). The performance of combined model of EDIH and EDIP for boys is comparable to that of the combined model of EDIH, EDIP, and GI to assess the risk of neurodevelopmental delay (AUC [area under curve] 0.801 vs. AUC 0.830). Both values are higher than the AUC values achieved by models using either set of indicators individually.</p><p><strong>Conclusion: </strong>Our findings suggest that maternal consumption of diets with high insulinemic, inflammatory, or glycemic index properties may be associated with neurodevelopmental delays in children, particularly in boys. Higher insulinemic and inflammatory potentials in maternal diet may forecast neurodevelopmental delay in boys.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":"64 1","pages":"25"},"PeriodicalIF":4.1000,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Maternal insulinemic and inflammatory dietary patterns and risk of child neurodevelopmental delay.\",\"authors\":\"Haixia Wang, Ping Zu, Wanjun Yin, Lei Zhang, Liang Ruan, Xianxia Chen, Peng Zhu\",\"doi\":\"10.1007/s00394-024-03531-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Our aim was to assess the risk of higher insulinemic, inflammatory, and hyperglycemia potential in the diet during pregnancy with child neurodevelopmental delay.</p><p><strong>Methods: </strong>We enrolled 7,438 pregnant women participating in a prospective cohort study. The food frequency questionnaire was used to evaluate the empirical dietary index for hyperinsulinemia (EDIH), empirical dietary inflammatory pattern (EDIP), glycemic index (GI), and glycemic load (GL) during mid-pregnancy. Child neurodevelopmental assessment was conducted at 6-36 months postpartum using the Denver Developmental Screening Test-II (DDST-II) scale, and the Gesell Developmental Diagnosis Scale (GDDS) was administered to assess children who did not meet the criteria for passing the DDST-II screening.</p><p><strong>Results: </strong>We documented 540 incident child neurodevelopmental delay cases over 7,438 pregnant women (median follow-up: 2 years). Pregnant women exhibiting the high levels of hyperinsulinemic or proinflammatory components, or GI encountered an elevated risk of child neurodevelopmental delay; HRs (95% CI) comparing highest to lowest dietary index quintiles were EDIH 1.48 (1.07,2.04; P <sub>trend</sub> = 0.017), EDIP 1.39 (1.05,1.84; P <sub>trend</sub> = 0.019) and GI 1.36 (1.02,1.81; P <sub>trend</sub> = 0.038). In sex-stratified analyses, these results remained significant only in boys (P <sub>trend</sub> = 0.018 for EDIH, P <sub>trend</sub> = 0.028 for EDIP, P <sub>trend</sub> = 0.029 for GI). The performance of combined model of EDIH and EDIP for boys is comparable to that of the combined model of EDIH, EDIP, and GI to assess the risk of neurodevelopmental delay (AUC [area under curve] 0.801 vs. AUC 0.830). Both values are higher than the AUC values achieved by models using either set of indicators individually.</p><p><strong>Conclusion: </strong>Our findings suggest that maternal consumption of diets with high insulinemic, inflammatory, or glycemic index properties may be associated with neurodevelopmental delays in children, particularly in boys. Higher insulinemic and inflammatory potentials in maternal diet may forecast neurodevelopmental delay in boys.</p>\",\"PeriodicalId\":12030,\"journal\":{\"name\":\"European Journal of Nutrition\",\"volume\":\"64 1\",\"pages\":\"25\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2024-11-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00394-024-03531-7\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00394-024-03531-7","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
摘要
目的:我们的目的是评估孕期饮食中较高的胰岛素血症、炎症和高血糖潜能与儿童神经发育迟缓的风险:我们招募了 7438 名孕妇参与一项前瞻性队列研究。方法:我们招募了 7,438 名参与前瞻性队列研究的孕妇,采用食物频率调查问卷来评估孕中期的高胰岛素血症经验膳食指数(EDIH)、经验膳食炎症模式(EDIP)、血糖生成指数(GI)和血糖负荷(GL)。在产后 6-36 个月时使用丹佛发育筛查测试 II(DDST-II)量表进行儿童神经发育评估,并使用格塞尔发育诊断量表(GDDS)评估未达到 DDST-II 筛查标准的儿童:我们记录了 7,438 名孕妇中的 540 例儿童神经发育迟缓病例(中位数随访时间:2 年)。表现出高水平高胰岛素血症或促炎症成分或消化道疾病的孕妇罹患儿童神经发育迟缓的风险较高;最高与最低膳食指数五分位数比较的 HRs(95% CI)分别为 EDIH 1.48(1.07,2.04;P 趋势 = 0.017)、EDIP 1.39(1.05,1.84;P 趋势 = 0.019)和 GI 1.36(1.02,1.81;P 趋势 = 0.038)。在性别分层分析中,这些结果仅对男孩有显著意义(EDIH 的 P 趋势 = 0.018,EDIP 的 P 趋势 = 0.028,GI 的 P 趋势 = 0.029)。在评估男孩神经发育迟缓风险方面,EDIH 和 EDIP 的组合模型与 EDIH、EDIP 和 GI 的组合模型性能相当(AUC [曲线下面积] 0.801 vs. AUC 0.830)。这两个值都高于单独使用任何一组指标的模型所达到的 AUC 值:我们的研究结果表明,母亲食用高胰岛素血症、高炎症或高血糖指数的饮食可能与儿童(尤其是男孩)的神经发育迟缓有关。母亲饮食中较高的胰岛素血症和炎症潜能值可能预示着男孩的神经发育迟缓。
Maternal insulinemic and inflammatory dietary patterns and risk of child neurodevelopmental delay.
Purpose: Our aim was to assess the risk of higher insulinemic, inflammatory, and hyperglycemia potential in the diet during pregnancy with child neurodevelopmental delay.
Methods: We enrolled 7,438 pregnant women participating in a prospective cohort study. The food frequency questionnaire was used to evaluate the empirical dietary index for hyperinsulinemia (EDIH), empirical dietary inflammatory pattern (EDIP), glycemic index (GI), and glycemic load (GL) during mid-pregnancy. Child neurodevelopmental assessment was conducted at 6-36 months postpartum using the Denver Developmental Screening Test-II (DDST-II) scale, and the Gesell Developmental Diagnosis Scale (GDDS) was administered to assess children who did not meet the criteria for passing the DDST-II screening.
Results: We documented 540 incident child neurodevelopmental delay cases over 7,438 pregnant women (median follow-up: 2 years). Pregnant women exhibiting the high levels of hyperinsulinemic or proinflammatory components, or GI encountered an elevated risk of child neurodevelopmental delay; HRs (95% CI) comparing highest to lowest dietary index quintiles were EDIH 1.48 (1.07,2.04; P trend = 0.017), EDIP 1.39 (1.05,1.84; P trend = 0.019) and GI 1.36 (1.02,1.81; P trend = 0.038). In sex-stratified analyses, these results remained significant only in boys (P trend = 0.018 for EDIH, P trend = 0.028 for EDIP, P trend = 0.029 for GI). The performance of combined model of EDIH and EDIP for boys is comparable to that of the combined model of EDIH, EDIP, and GI to assess the risk of neurodevelopmental delay (AUC [area under curve] 0.801 vs. AUC 0.830). Both values are higher than the AUC values achieved by models using either set of indicators individually.
Conclusion: Our findings suggest that maternal consumption of diets with high insulinemic, inflammatory, or glycemic index properties may be associated with neurodevelopmental delays in children, particularly in boys. Higher insulinemic and inflammatory potentials in maternal diet may forecast neurodevelopmental delay in boys.
期刊介绍:
The European Journal of Nutrition publishes original papers, reviews, and short communications in the nutritional sciences. The manuscripts submitted to the European Journal of Nutrition should have their major focus on the impact of nutrients and non-nutrients on
immunology and inflammation,
gene expression,
metabolism,
chronic diseases, or
carcinogenesis,
or a major focus on
epidemiology, including intervention studies with healthy subjects and with patients,
biofunctionality of food and food components, or
the impact of diet on the environment.