Association between low-carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history: based on the National Health and Nutrition Examination Survey database

Background: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications during pregnancy, and is associated with a significantly increased risk of postpartum chronic kidney disease (CKD). Although a low-carbohydrate diet (LCD) is recommended for glycaemic management in GDM...

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Main Authors: Junli Zhang, Youlian Dong
Format: Article
Language:English
Published: Swedish Nutrition Foundation 2025-07-01
Series:Food & Nutrition Research
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Online Access:https://foodandnutritionresearch.net/index.php/fnr/article/view/10986/19702
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author Junli Zhang
Youlian Dong
author_facet Junli Zhang
Youlian Dong
author_sort Junli Zhang
collection DOAJ
description Background: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications during pregnancy, and is associated with a significantly increased risk of postpartum chronic kidney disease (CKD). Although a low-carbohydrate diet (LCD) is recommended for glycaemic management in GDM patients, its long-term impact on kidney health remains unclear. Objective: To address this knowledge gap, this study aimed to investigate the association between LCD and the risk of CKD in women with a history of GDM, providing evidence for optimising postpartum dietary intervention strategies. Method: GDM data from National Health and Nutrition Examination Survey database (2009–2018) were used, with LCD as an independent variable and CKD as a dependent variable. Univariate and multivariate logistic regression analyses were applied to investigate factors related to CKD. Stratified and sub-group analyses were conducted to investigate association of LCD with CDK. Restricted cubic splines (RCS) were utilised to analyse non-linear relationship between the two variables. Results: There were 701 samples in all (CKD: n = 130; non-CKD: n = 571). The LCD score and CKD risk were shown to have a significant positive association (Odds Ratio [OR] > 1, P < 0.05) in multivariate weighted logistic regression model. The link between LCD score and CKD was strongly impacted by race, body mass index (BMI), and smoking status (P for interaction < 0.05). In patients who presently smoke and use alcohol, stratified analysis showed a substantial positive correlation (P < 0.05) between LCD score and CKD risk. RCSs curve indicated a potential linear relationship (P-non-linear = 0.9561) between risk of LCD and CKD, with an LCD score of 10 serving as the criterion threshold for CKD risk and OR < 1 when LCD < 10, signifying a protective factor. Conclusion: Among women with GDM, higher LCD scores showed a significant positive correlation with CKD risk, particularly in sub-groups with smoking or alcohol consumption habits. The study suggests the need for careful evaluation of the long-term renal safety of LCD and highlights the importance of developing individualised dietary plans for high-risk populations.
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spelling doaj-art-1ed4aefb93684637be1027de90dc3f092025-08-20T03:44:01ZengSwedish Nutrition FoundationFood & Nutrition Research1654-661X2025-07-01691910.29219/fnr.v69.1098610986Association between low-carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history: based on the National Health and Nutrition Examination Survey databaseJunli Zhang0Youlian Dong1Department of Obstetrics, Guangyuan Central Hospital, Sichuan Province, ChinaDepartment of Obstetrics, the First People’s Hospital of Xiaoshan District, Hangzhou, ChinaBackground: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications during pregnancy, and is associated with a significantly increased risk of postpartum chronic kidney disease (CKD). Although a low-carbohydrate diet (LCD) is recommended for glycaemic management in GDM patients, its long-term impact on kidney health remains unclear. Objective: To address this knowledge gap, this study aimed to investigate the association between LCD and the risk of CKD in women with a history of GDM, providing evidence for optimising postpartum dietary intervention strategies. Method: GDM data from National Health and Nutrition Examination Survey database (2009–2018) were used, with LCD as an independent variable and CKD as a dependent variable. Univariate and multivariate logistic regression analyses were applied to investigate factors related to CKD. Stratified and sub-group analyses were conducted to investigate association of LCD with CDK. Restricted cubic splines (RCS) were utilised to analyse non-linear relationship between the two variables. Results: There were 701 samples in all (CKD: n = 130; non-CKD: n = 571). The LCD score and CKD risk were shown to have a significant positive association (Odds Ratio [OR] > 1, P < 0.05) in multivariate weighted logistic regression model. The link between LCD score and CKD was strongly impacted by race, body mass index (BMI), and smoking status (P for interaction < 0.05). In patients who presently smoke and use alcohol, stratified analysis showed a substantial positive correlation (P < 0.05) between LCD score and CKD risk. RCSs curve indicated a potential linear relationship (P-non-linear = 0.9561) between risk of LCD and CKD, with an LCD score of 10 serving as the criterion threshold for CKD risk and OR < 1 when LCD < 10, signifying a protective factor. Conclusion: Among women with GDM, higher LCD scores showed a significant positive correlation with CKD risk, particularly in sub-groups with smoking or alcohol consumption habits. The study suggests the need for careful evaluation of the long-term renal safety of LCD and highlights the importance of developing individualised dietary plans for high-risk populations.https://foodandnutritionresearch.net/index.php/fnr/article/view/10986/19702chronic kidney diseasecross-sectional studygestational diabetes mellituslow-carbohydrate dietnational health and nutrition examination survey
spellingShingle Junli Zhang
Youlian Dong
Association between low-carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history: based on the National Health and Nutrition Examination Survey database
Food & Nutrition Research
chronic kidney disease
cross-sectional study
gestational diabetes mellitus
low-carbohydrate diet
national health and nutrition examination survey
title Association between low-carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history: based on the National Health and Nutrition Examination Survey database
title_full Association between low-carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history: based on the National Health and Nutrition Examination Survey database
title_fullStr Association between low-carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history: based on the National Health and Nutrition Examination Survey database
title_full_unstemmed Association between low-carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history: based on the National Health and Nutrition Examination Survey database
title_short Association between low-carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history: based on the National Health and Nutrition Examination Survey database
title_sort association between low carbohydrate diet and chronic kidney disease in population with gestational diabetes mellitus history based on the national health and nutrition examination survey database
topic chronic kidney disease
cross-sectional study
gestational diabetes mellitus
low-carbohydrate diet
national health and nutrition examination survey
url https://foodandnutritionresearch.net/index.php/fnr/article/view/10986/19702
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