Global Centre for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Diabetes Care. 2023 Apr 1;46(4):722-732. doi: 10.2337/dc22-1892.
We prospectively evaluated plasma amino acids (AAs) in early pregnancy and midpregnancy and their interplay with phospholipid fatty acids (FAs) in association with gestational diabetes mellitus (GDM) risk.
From a longitudinal pregnancy cohort of 2,802 individuals, concentrations of 24 plasma AAs at 10-14 and 15-26 gestational weeks (GW) were assessed among 107 GDM case subjects and 214 non-GDM control subjects. We estimated adjusted odds ratios (OR) and 95% CI for the associations of plasma AAs and the joint associations of plasma AAs and phospholipid FAs with GDM risk, adjusting for risk factors including age, prepregnancy BMI, and family history of diabetes.
Glycine at 10-14 GW was inversely associated with GDM (adjusted OR [95% CI] per SD increment: 0.55 [0.39-0.79]). Alanine, aspartic acid, and glutamic acid at 10-14 GW were positively associated with GDM (1.43 [1.08-1.88], 1.41 [1.11-1.80], and 1.39 [0.98-1.98]). At 15-26 GW, findings for glycine, alanine, aspartic acid, and the glutamine-to-glutamic acid ratio were consistent with the directions observed at 10-14 GW. Isoleucine, phenylalanine, and tyrosine were positively associated with GDM (1.64 [1.19-2.27], 1.15 [0.87-1.53], and 1.56 [1.16-2.09]). All P values for linear trend were <0.05. Several AAs and phospholipid FAs were significantly and jointly associated with GDM. For instance, the lowest risk was observed among women with higher glycine and lower even-chain saturated FAs at 10-14 GW (adjusted OR [95% CI] 0.15 [0.06, 0.37]).
Plasma AAs may be implicated in GDM development starting in early pregnancy. Associations of AAs with GDM may be enhanced in the copresence of phospholipid FA profile.
我们前瞻性地评估了妊娠早期和中期的血浆氨基酸（AA）及其与妊娠糖尿病（GDM）风险相关的磷脂脂肪酸（FA）的相互作用。
在 2802 名个体的纵向妊娠队列中，在 10-14 周和 15-26 周妊娠（GW）时评估了 107 例 GDM 病例和 214 例非 GDM 对照中 24 种血浆 AA 的浓度。我们估计了血浆 AA 与 GDM 风险的关联的调整比值比（OR）和 95％置信区间（CI），并调整了包括年龄、孕前 BMI 和糖尿病家族史在内的危险因素。
10-14 GW 时甘氨酸与 GDM 呈负相关（SD 递增时的调整 OR [95％CI]：0.55 [0.39-0.79]）。10-14 GW 时丙氨酸、天冬氨酸和谷氨酸与 GDM 呈正相关（1.43 [1.08-1.88]、1.41 [1.11-1.80]和 1.39 [0.98-1.98]）。在 15-26 GW 时，甘氨酸、丙氨酸、天冬氨酸和谷氨酰胺/谷氨酸比值的发现与 10-14 GW 时的方向一致。异亮氨酸、苯丙氨酸和酪氨酸与 GDM 呈正相关（1.64 [1.19-2.27]、1.15 [0.87-1.53]和 1.56 [1.16-2.09]）。所有线性趋势 P 值均 <0.05。一些 AA 和磷脂 FA 与 GDM 显著且共同相关。例如，在 10-14 GW 时，甘氨酸较高且偶数链饱和 FA 较低的女性风险最低（调整后的 OR [95％CI] 0.15 [0.06，0.37]）。
妊娠早期血浆 AA 可能与 GDM 的发展有关。AA 与 GDM 的关联可能在磷脂 FA 谱的共存下增强。
