Harold Hamm Diabetes Center, The University of Oklahoma Health Science Center, Oklahoma City, OK, United States.
Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, The University of Colorado Anschutz Medical Center, Aurora, CO, United States.
Front Endocrinol (Lausanne). 2022 Jul 28;13:921464. doi: 10.3389/fendo.2022.921464. eCollection 2022.
Gestational diabetes mellitus (GDM) is associated with considerable imbalances in intestinal microbiota that may underlie pathological conditions in both mothers and infants. To more definitively identify these alterations, we evaluated the maternal and infant gut microbiota through the shotgun metagenomic analysis of a subset of stool specimens collected from a randomized, controlled trial in diet-controlled women with GDM. The women were fed either a CHOICE diet (60% complex carbohydrate/25% fat/15% protein, n=18) or a conventional diet (CONV, 40% complex carbohydrate/45% fat/15% protein, n=16) from 30 weeks' gestation through delivery. In contrast to other published studies, we designed the study to minimize the influence of other dietary sources by providing all meals, which were eucaloric and similar in fiber content. At 30 and 37 weeks' gestation, we collected maternal stool samples; performed the fasting measurements of glucose, glycerol, insulin, free fatty acids, and triglycerides; and administered an oral glucose tolerance test (OGTT) to measure glucose clearance and insulin response. Infant stool samples were collected at 2 weeks, 2 months, and 4-5 months of age. Maternal glucose was controlled to conventional targets in both diets, with no differences in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). No differences in maternal alpha or beta diversity between the two diets from baseline to 37 weeks' gestation were observed. However, women on CHOICE diet had higher levels of , specifically , compared with women on CONV. Species-level taxa varied significantly with fasting glycerol, fasting glucose, and glucose AUC after the OGTT challenge. Maternal diet significantly impacted the patterns of infant colonization over the first 4 months of life, with CHOICE infants showing increased microbiome alpha diversity (richness), greater , and decreased over time. Overall, these results suggest that an isocaloric GDM diet containing greater complex carbohydrates with reduced fat leads to an ostensibly beneficial effect on the maternal microbiome, improved infant gut microbiome diversity, and reduced opportunistic pathogens capable of playing a role in obesity and immune system development. These results highlight the critical role a maternal diet has in shaping the maternal and infant microbiome in women with GDM.
妊娠糖尿病（GDM）与肠道微生物群的显著失衡有关，这种失衡可能是母亲和婴儿出现病理状况的基础。为了更明确地确定这些变化，我们通过对来自 GDM 饮食控制女性的随机对照试验中收集的一部分粪便样本进行 shotgun 宏基因组分析，评估了产妇和婴儿的肠道微生物群。这些女性从 30 孕周开始至分娩时分别接受 CHOICE 饮食（60%复合碳水化合物/25%脂肪/15%蛋白质，n=18）或传统饮食（CONV，40%复合碳水化合物/45%脂肪/15%蛋白质，n=16）。与其他已发表的研究不同，我们通过提供所有膳食来设计该研究，这些膳食是等热量的，并且膳食纤维含量相似，从而最大限度地减少了其他膳食来源的影响。在 30 周和 37 周时，我们收集了产妇粪便样本；进行了空腹血糖、甘油、胰岛素、游离脂肪酸和甘油三酯测量；并进行了口服葡萄糖耐量试验（OGTT）以测量葡萄糖清除率和胰岛素反应。在 2 周、2 个月和 4-5 个月时收集婴儿粪便样本。两种饮食的产妇血糖均控制在常规目标范围内，胰岛素抵抗稳态模型评估（HOMA-IR）无差异。从基线到 37 孕周，两种饮食之间的产妇 alpha 或 beta 多样性没有差异。然而，与 CONV 组相比，CHOICE 组的 水平更高，特别是 水平更高。空腹甘油、OGTT 后空腹血糖和 AUC 与物种水平分类群显著相关。产妇饮食显著影响婴儿在生命的头 4 个月的定植模式，CHOICE 婴儿的微生物组 alpha 多样性（丰富度）增加， 增加， 减少。总的来说，这些结果表明，含有更多复杂碳水化合物和更少脂肪的等热量 GDM 饮食会对产妇微生物群产生明显有益的影响，改善婴儿肠道微生物群多样性，并减少可能在肥胖和免疫系统发育中发挥作用的机会性病原体。这些结果强调了产妇饮食在塑造 GDM 女性的产妇和婴儿微生物群方面的关键作用。
