Department of Medical Laboratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China.
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
J Endocrinol Invest. 2020 Aug;43(8):1097-1103. doi: 10.1007/s40618-020-01196-7. Epub 2020 Feb 22.
To assess the longitudinal associations between maternal total bile acid (TBA) levels during early mid-pregnancy and the subsequent risk of gestational diabetes mellitus (GDM).
In a prospective cohort study, pregnant women who were enrolled prior to gestational week 16 were followed until delivery. TBA levels were tested during weeks 14-18 of gestation. Using logistic regression, we analyzed the associations between quartiles of TBA and GDM based on a 75-g oral glucose tolerance test (OGTT) at 24-28 gestational weeks.
The GDM rate was 7.9% (114/1441). The mean TBA level was higher in women with GDM than in those without GDM (2.1 ± 2.0 vs 1.5 ± 1.0 µmol/L, P = 0.000). The highest TBA level quartile (2.1-10.7 µmol/L) had a 1.78-fold (95% CI 1.01, 3.14) increased risk of GDM compared with that of the lowest quartile (0.0-0.8 µmol/L) after adjusting for pre-pregnancy body mass index (BMI), gestational, age at TBA test and other confounders. High TBA levels were involved in the fasting glucose level rather than that at 1 h and 2 h after OGTT in all participants.
Pregnant women with higher serum TBA levels during early mid-pregnancy have a higher risk of developing GDM. TBA may be a new risk factor for GDM.
评估早孕期中期孕妇总胆汁酸（TBA）水平与随后发生妊娠糖尿病（GDM）的风险之间的纵向关联。
在一项前瞻性队列研究中，在妊娠 16 周之前入组的孕妇一直随访到分娩。在妊娠 14-18 周时检测 TBA 水平。采用 logistic 回归分析，根据 24-28 孕周 75g 口服葡萄糖耐量试验（OGTT），分析 TBA 四分位与 GDM 的关系。
GDM 发生率为 7.9%（114/1441）。GDM 组孕妇的 TBA 水平平均值高于非 GDM 组（2.1±2.0 vs. 1.5±1.0 µmol/L，P=0.000）。与最低四分位数（0.0-0.8 µmol/L）相比，TBA 水平最高四分位数（2.1-10.7 µmol/L）的 GDM 风险增加 1.78 倍（95%CI 1.01，3.14），调整了孕前体重指数（BMI）、妊娠、TBA 检测时年龄和其他混杂因素后。在所有参与者中，高 TBA 水平与空腹血糖水平相关，而与 OGTT 后 1h 和 2h 的血糖水平无关。
早孕期中期血清 TBA 水平较高的孕妇发生 GDM 的风险较高。TBA 可能是 GDM 的一个新的危险因素。
