McArthur Kristen L, Zhang Mingyu, Hong Xiumei, Wang Guoying, Buckley Jessie P, Wang Xiaobin, Mueller Noel T
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Curr Dev Nutr. 2022 Jun 21;6(7):nzac108. doi: 10.1093/cdn/nzac108. eCollection 2022 Jul.
Trimethylamine N-oxide (TMAO) and its precursors choline, betaine, and carnitine have been associated with cardiometabolic disease in nonpregnant adults. However, studies examining TMAO and its precursors in relation to cardiometabolic conditions during pregnancy are lacking.
The primary objective was to estimate the association of TMAO and its precursors in maternal and cord plasma with gestational diabetes mellitus (GDM) and pre-eclampsia (PE) among women in the Boston Birth Cohort. A secondary objective was to determine whether associations vary by race/ethnicity.
ORs for each outcome according to tertiles and to an SD increment of TMAO, choline, betaine, and carnitine were estimated using logistic regression. Final models were adjusted for covariates.
Among 1496 women, 115 women had GDM and 159 had PE during the index pregnancy. Intermetabolite correlations of TMAO and its precursors were stronger within cord plasma ( = 0.38-0.87) than within maternal plasma ( = 0.08-0.62). Maternal TMAO was associated with higher odds of GDM (third compared with first tertile OR: 1.75; 95% CI: 1.04, 2.94), whereas maternal choline, betaine, and carnitine were not associated with GDM. Maternal TMAO and choline were not associated with PE, whereas carnitine was associated with higher (OR: 1.86; 95% CI: 1.18, 2.94) and betaine with lower odds of PE (OR: 0.37; 95% CI: 0.23, 0.59). In cord plasma, TMAO was not associated with GDM or PE, but choline, betaine, and carnitine were associated with higher odds of PE (OR: 3.11; 95% CI: 1.62, 5.96; OR: 2.65; 95% CI: 1.42, 4.93; OR: 2.56; 95% CI: 1.39, 4.69, respectively). Cord choline was associated with lower odds of GDM (OR: 0.52; 95% CI: 0.27, 0.99), whereas other cord metabolites were not significantly associated with GDM. Associations did not vary by race/ethnicity.
TMAO and its precursors were associated with GDM and PE, but the associations differed based on the metabolite medium (maternal compared with cord plasma).This trial was registered at clinicaltrials.gov as NCT03228875.
氧化三甲胺（TMAO）及其前体胆碱、甜菜碱和肉碱与非孕期成年人的心脏代谢疾病有关。然而，缺乏关于孕期TMAO及其前体与心脏代谢状况关系的研究。
主要目的是评估波士顿出生队列中女性母体和脐带血浆中TMAO及其前体与妊娠期糖尿病（GDM）和子痫前期（PE）的关联。次要目的是确定这些关联是否因种族/族裔而异。
使用逻辑回归估计根据TMAO、胆碱、甜菜碱和肉碱的三分位数以及标准差增量得出的每种结局的比值比（OR）。最终模型对协变量进行了调整。
在1496名女性中，115名女性在本次妊娠期间患有GDM，159名患有PE。TMAO及其前体在脐带血浆中的代谢物间相关性（=0.38 - 0.87）比在母体血浆中更强（=0.08 - 0.62）。母体TMAO与GDM的较高发病几率相关（第三三分位数与第一三分位数相比，OR：1.75；95%置信区间：1.04，2.94），而母体胆碱、甜菜碱和肉碱与GDM无关。母体TMAO和胆碱与PE无关，而肉碱与PE的较高发病几率相关（OR：1.86；95%置信区间：1.18，2.94），甜菜碱与PE的较低发病几率相关（OR：0.37；95%置信区间：0.23，0.59）。在脐带血浆中，TMAO与GDM或PE无关，但胆碱、甜菜碱和肉碱与PE的较高发病几率相关（分别为OR：3.11；95%置信区间：1.62，5.96；OR：2.65；95%置信区间：1.42，4.93；OR：2.56；95%置信区间：1.39，4.69）。脐带胆碱与GDM的较低发病几率相关（OR：0.52；95%置信区间：0.27，0.99），而其他脐带代谢物与GDM无显著关联。这些关联不因种族/族裔而异。结论：TMAO及其前体与GDM和PE有关，但这些关联因代谢物介质（母体血浆与脐带血浆）而异。本试验在clinicaltrials.gov上注册为NCT03228875。
