妊娠早期母体叶酸与口服糖耐量试验中血糖指标的关系：系统回顾和荟萃分析

IF 3.2 Q2 NUTRITION & DIETETICS

Current Developments in Nutrition Pub Date : 2025-09-01 DOI:10.1016/j.cdnut.2025.107531

Nishanthi Periyathambi , Swetha Sampathkumar , Nithya Sukumar , Yonas Ghebremichael-Weldeselassie , Ponnusamy Saravanan

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引用次数: 0

摘要

叶酸在胎儿发育中起着至关重要的作用，但其与母体葡萄糖代谢的关系尚不明确。最近的荟萃分析表明，高叶酸与妊娠期糖尿病风险之间存在相关性；然而，其与不同血糖参数的关系尚未探讨。目的综合证据，探讨妊娠早期循环叶酸（妊娠16周）与24 ~ 28周口服糖耐量试验（OGTT）血糖指标的关系。方法系统检索截至2025年6月25日的数据库，研究妊娠早期叶酸与孕妇血糖指数的关系。采用纽卡斯尔-渥太华量表评估研究质量。采用随机效应模型汇总血清/血浆叶酸的标准化效应量（std. β系数）。进行亚组和敏感性分析以解释研究间的异质性。结果本meta分析纳入了10项研究。妊娠早期母体叶酸水平与OGTT时测量的血糖指数呈正相关。妊娠早期血清叶酸增加1个标准差（nmol/L）与空腹升高0.01[95%可信区间（CI）：−0.001,0.01]mmol/L、1小时血糖升高0.17 (95% CI: 0.15, 0.18) mmol/L和2小时血糖升高0.10 (95% CI: 0.05, 0.15) mmol/L相关。在OGTT亚组分析中，妊娠中期循环叶酸与OGTT时测量的血糖水平之间存在类似的正相关，尽管存在研究间异质性（I2>70%）。结论sour分析提示妊娠早期较高的叶酸水平与OGTT时较高的血糖水平可能存在关联。然而，考虑到方法学的局限性和本综述中纳入的研究数量有限，这些发现应谨慎解释。该试验在普洛斯彼罗注册为CRD42021255022。

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Association between Early Pregnancy Maternal Folate and Glycemic Indices at Oral Glucose Tolerance Test: A Systematic Review and Meta-analysis

Background

Folate plays a crucial role in fetal development, but its relationship with maternal glucose metabolism remains inconclusive. Recent meta-analyses have suggested a correlation between high folate and risk of gestational diabetes mellitus in pregnancy; however, its association with different glycemic parameters has not yet been explored.

Objectives

This study aims to comprehensively synthesize evidence and test the association between early pregnancy circulating folate (<16 wk of gestation) and glycemic indices measured during oral glucose tolerance testing (OGTT) at 24–28 wk.

Methods

We conducted a systematic search of databases up to 25 June, 2025, examining the relationship between early pregnancy folate and maternal glycemic indices. Study quality was assessed by Newcastle-Ottawa Scale. Standardized effect sizes (std. β coefficients) for serum/plasma folate were pooled using a random-effects model. Subgroup and sensitivity analyses were performed to account for between-study heterogeneity.

Results

Ten studies were included in this meta-analysis. Early pregnancy maternal folate levels were positively associated with glycemic indices measured at the time of OGTT. One standard deviation (nmol/L) increase in early pregnancy serum folate was associated with 0.01 [95% confidence interval (CI): −0.001, 0.01] mmol/L higher fasting, 0.17 (95% CI: 0.15, 0.18) mmol/L higher 1-h glucose, and 0.10 (95% CI: 0.05, 0.15) mmol/L higher 2-h glucose levels during OGTT Subgroup analyses revealed similar positive association between mid-pregnancy circulating folate and glucose levels measured at the time of OGTT despite substantial between-study heterogeneity (I²>70%).

Conclusions

Our analysis suggests a possible association between higher early pregnancy folate levels and higher glucose levels at the time of OGTT. However, these findings should be interpreted cautiously, given the methodological limitations and the limited number of studies included in this review.

This trial was registered at PROSPERO as CRD42021255022.

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