Liu Kai, Clarke Georgia S, Grieger Jessica A
Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
Diabetes Metab Res Rev. 2025 Jan;41(1):e70026. doi: 10.1002/dmrr.70026.
To synthesise the evidence from clinical trials and observational studies using omics techniques to investigate the impact of diet and lifestyle factors on metabolite profile in pregnancy, and in the prevention and management of gestational diabetes mellitus (GDM).
A systematic literature search was performed using PubMed, Ovid, CINAHL, and Web of Science databases in October 2023 and updated in September 2024. Inclusion criteria were randomised controlled trials (RCT) or non-RCTs in pregnant women with or without GDM, that measured diet and lifestyle factors, and which applied post-transcriptional omics approaches. Risk of bias was assessed using the ROBINS-I for non-RCTs and ROB-2 tool for RCTs. The results of all studies are narratively synthesised.
Of 6293 studies identified, eight observational studies and three RCTs comprising 2639 pregnant women were included. Three studies reported on changes in diet-related metabolic phenotypes during pregnancy; however, the impact of certain foods on the metabolome and risk for GDM was less clear. Compared with women without GDM, women with GDM had a worse deterioration in metabolites, including saturated fatty acids, branched chain amino acids and purine degradation metabolites. There is limited evidence that conventional dietary treatment for GDM may modify the metabolome in women with GDM.
Metabolome profiles in pregnancy may be altered by certain dietary choices; however, it is inconclusive whether improved diet related metabolite profiles have a beneficial impact in the prevention or management of GDM. High quality studies with larger sample sizes are needed to better understand the role that maternal nutrition plays in modulating the maternal metabolome, not only for a healthy pregnancy but also for the prevention and management of GDM.
综合临床试验和观察性研究的证据，这些研究使用组学技术来调查饮食和生活方式因素对孕期代谢物谱的影响，以及在妊娠期糖尿病（GDM）的预防和管理中的作用。
2023年10月使用PubMed、Ovid、CINAHL和Web of Science数据库进行了系统的文献检索，并于2024年9月更新。纳入标准为有或无GDM的孕妇的随机对照试验（RCT）或非RCT，这些试验测量了饮食和生活方式因素，并应用了转录后组学方法。使用ROBINS - I评估非RCT的偏倚风险，使用ROB - 2工具评估RCT的偏倚风险。对所有研究的结果进行叙述性综合。
在识别出的6293项研究中，纳入了八项观察性研究和三项RCT，共2639名孕妇。三项研究报告了孕期饮食相关代谢表型的变化；然而，某些食物对代谢组和GDM风险的影响尚不清楚。与无GDM的女性相比，患有GDM的女性代谢物恶化更严重，包括饱和脂肪酸、支链氨基酸和嘌呤降解代谢物。仅有有限的证据表明，GDM的传统饮食治疗可能会改变患有GDM女性的代谢组。
孕期的代谢组谱可能会因某些饮食选择而改变；然而，改善与饮食相关的代谢物谱是否对GDM的预防或管理有有益影响尚无定论。需要开展更大样本量的高质量研究，以更好地了解母体营养在调节母体代谢组中所起的作用，这不仅关乎健康妊娠，也关乎GDM的预防和管理。
