Gagnon Marianne, Trottier Jocelyn, Weisnagel S John, Gagnon Claudia, Carreau Anne-Marie, Barbier Olivier, Morisset Anne-Sophie
School of Nutrition Laval University Quebec Canada.
Endocrinology and Nephrology Unit CHU of Québec-Université Laval Research Center Quebec Canada.
Health Sci Rep. 2021 Feb 10;4(1):e243. doi: 10.1002/hsr2.243. eCollection 2021 Mar.
Bile acids are known to contribute to hepatic glucose and lipid metabolism regulation. Although glucose homeostasis sustains well-characterized modifications during uncomplicated pregnancies, changes in bile acids concentrations and relative proportions throughout pregnancy remain unknown. Furthermore, literature shows strong associations between bile acids profiles and glucose homeostasis under normal metabolic conditions. We seek, first, to characterize bile acids' metabolic changes across trimesters and, second, to evaluate associations between changes in bile acids and glucose homeostasis indexes in the first and second trimesters.
A total of 78 women were recruited and followed at each trimester of pregnancy. Fasting serum samples were collected once per trimester in which quantitative measurement of 30 different bile acids' molecules were performed using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Glucose homeostasis indexes were measured in the first and second trimesters, after a 12-hour fast and following a 75 g oral glucose tolerance test.
Total bile acids increased from the first trimester to late pregnancy, along with the cholic acid: chenodeoxycholic acid and conjugated: unconjugated bile acids ratios. Changes in bile acids were positively associated with elevated peripheral and hepatic insulin resistance indexes, as well as with trimestral changes in these indexes.
Our findings suggest that modifications occurring in bile acids' profiles during normal pregnancy are associated with changes in glucose homeostasis. Further research is needed to examine the nature of those associations and the possible outcome of bile acids changes on pathological glucose homeostasis alterations during pregnancy.
已知胆汁酸有助于调节肝脏葡萄糖和脂质代谢。尽管在正常妊娠期间葡萄糖稳态维持着特征明确的变化，但整个孕期胆汁酸浓度和相对比例的变化仍不清楚。此外，文献表明在正常代谢条件下胆汁酸谱与葡萄糖稳态之间存在密切关联。我们首先试图描述孕期各阶段胆汁酸的代谢变化，其次评估孕早期和孕中期胆汁酸变化与葡萄糖稳态指标之间的关联。
共招募了78名女性，并在孕期各阶段对其进行跟踪。每三个月采集一次空腹血清样本，使用液相色谱串联质谱法（LC-MS/MS）对30种不同胆汁酸分子进行定量测量。在孕早期和孕中期，禁食12小时后，进行75克口服葡萄糖耐量试验，然后测量葡萄糖稳态指标。
从孕早期到妊娠晚期，总胆汁酸增加，同时胆酸：鹅去氧胆酸以及结合型：非结合型胆汁酸的比例也增加。胆汁酸的变化与外周和肝脏胰岛素抵抗指数升高以及这些指数的孕期变化呈正相关。
我们的研究结果表明，正常妊娠期间胆汁酸谱的变化与葡萄糖稳态的变化有关。需要进一步研究来探讨这些关联的性质以及胆汁酸变化对孕期病理性葡萄糖稳态改变可能产生的结果。
