Department of Obstetrics & Gynecology, St. Michael's Hospital & University of Toronto, Toronto, ON, Canada; Department of Obstetrics and Gynecology, Assuta Ashdod University Hospital, Ashdod, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
The Keenan Research Center for Biomedical Science of St. Michael's Hospital, Toronto, Ontario, Canada.
Nutr Res. 2018 Jul;55:57-64. doi: 10.1016/j.nutres.2018.04.010. Epub 2018 Apr 21.
Both insufficiency and excess of one-carbon nutrients (folate, choline, vitamins B6 and B12) during pregnancy have been associated with gestational diabetes mellitus (GDM). However, the precise nature of this association has not been clearly established. We hypothesized that GDM may affect one-carbon nutrients concentrations in the fetus, thus possibly participating in epigenetic programing of the offspring. Maternal blood was collected at recruitment (12-16 weeks). At delivery (28-42 weeks), both maternal and cord blood were collected. Blood concentrations of one-carbon nutrients and their metabolites were compared between the two groups. A total of 368 women were included in the study, of whom 19 (5.6%) were later diagnosed with GDM. No significant differences were found in maternal blood concentrations of one-carbon nutrients and their metabolites between the GDM and control groups at recruitment or at delivery. In cord blood, however, serum folate (87.7 [IQR 70.4-103.9] vs 66.6 [IQR 45.5-80.3] nmol/L, P = .025) and plasma TMAO (2.82 [IQR 1.3-3.2] vs 1.35 [IQR 1.0-2.0] μmol/L, P = .017) concentrations were higher, while plasma betaine concentrations were lower (17.5 [IQR 16.3-19.4] vs 21.1 [IQR 18.0-24.1] μmol/L, P = .019) in infants born to mothers with GDM compared with control. Our data suggest that while maternal blood concentrations of one-carbon nutrients and their metabolites may not affect the risk of GDM, GDM may alter concentrations of serum folate, plasma betaine and TMAO in cord blood. These alterations in one-carbon nutrient concentrations in fetal circulation may impact epigenetic programing, thereby contributing to physiologic changes and disease susceptibility in adulthood associated with GDM offspring.
在妊娠期间，一碳营养素（叶酸、胆碱、维生素 B6 和 B12）的不足和过量都与妊娠期糖尿病（GDM）有关。然而，这种关联的确切性质尚未明确。我们假设 GDM 可能会影响胎儿的一碳营养素浓度，从而可能参与后代的表观遗传编程。在招募时（12-16 周）采集母亲血液。在分娩时（28-42 周），采集母亲和脐带血。比较两组母亲血液中的一碳营养素及其代谢物浓度。共有 368 名妇女纳入研究，其中 19 名（5.6%）后来被诊断为 GDM。在招募或分娩时，GDM 组和对照组母亲血液中的一碳营养素及其代谢物浓度无显著差异。然而，在脐带血中，血清叶酸（87.7[IQR 70.4-103.9]与 66.6[IQR 45.5-80.3]nmol/L，P=0.025）和血浆 TMAO（2.82[IQR 1.3-3.2]与 1.35[IQR 1.0-2.0]μmol/L，P=0.017）浓度较高，而血浆甜菜碱浓度较低（17.5[IQR 16.3-19.4]与 21.1[IQR 18.0-24.1]μmol/L，P=0.019）在 GDM 母亲所生孩子中。我们的数据表明，虽然母亲血液中的一碳营养素及其代谢物浓度可能不会影响 GDM 的风险，但 GDM 可能会改变脐带血中血清叶酸、血浆甜菜碱和 TMAO 的浓度。胎儿循环中一碳营养素浓度的这些变化可能会影响表观遗传编程，从而导致与 GDM 后代相关的成年期生理变化和疾病易感性。
