Chen Geng-Dong, Pang Ting-Ting, Li Peng-Sheng, Ye Shao-Xin, Gou Xiao-Yan, Wang Hai-Yan, Lin Dong-Xin, Fan Da-Zhi, Deng Lu-Sha, Wang Li-Juan, Zhou Zi-Xing
Foshan Institute of Fetal Medicine, Foshan Women and Children Hospital Affiliated to Guangdong Medical University, Foshan, Guangdong, China.
Foshan Key Laboratory of Stem Cell and Maternal-Child Health, Foshan Women and Children Hospital, Foshan, China.
Front Nutr. 2025 Jun 16;12:1587863. doi: 10.3389/fnut.2025.1587863. eCollection 2025.
We aimed to provide a comprehensive understanding of the associations between Trimethylamine-N-oxide (TMAO), its precursor and gestational diabetes mellitus (GDM).
In this prospective study, 940 women were included in a Chinese single -center pregnant cohort. First trimester plasma concentrations of TMAO and its precursors (betaine, choline, L-carnitine, and trimethylamine) were measured using UPLC-ESI-MS/MS. GDM and specific abnormal glucose levels (fasting glucose; one-hour post-load glucose, 1-h PG; two-hour post load glucose, 2-h PG; and 1-h PG ≥ 8.6 mmol/L) were assessed through oral glucose tolerance tests. First-trimester plasma concentrations of TMAO and its precursors were divided into quartile groups (bottom, Q1; middle, Q2 and Q3; top, Q4).
Among the subjects, 167 (17.8%) were found to have GDM. After adjusting for potential covariates, the lower groups (Q1) of L-carnitine were associated with a higher risk of GDM compared to the reference group (middle quartiles). The OR (95% CI, p) was1.56 (1.04, 2.35, = 0.032) for L-carnitine. Specifically, the associations were mainly derived from L-carnitine and abnormal 1-h PG. The ORs (95% CI, p) were 2.00 (1.24, 3.24, = 0.005).
Low plasma levels (bottom vs. middle quartiles) of L-carnitine the first-trimester pregnancy were associated with a higher risk of GDM and abnormal 1-h PG in Chinese pregnant women.
我们旨在全面了解氧化三甲胺（TMAO）及其前体与妊娠期糖尿病（GDM）之间的关联。
在这项前瞻性研究中，940名女性被纳入中国单中心孕妇队列。使用超高效液相色谱-电喷雾串联质谱法（UPLC-ESI-MS/MS）测量孕早期血浆中TMAO及其前体（甜菜碱、胆碱、左旋肉碱和三甲胺）的浓度。通过口服葡萄糖耐量试验评估GDM和特定的异常血糖水平（空腹血糖；负荷后1小时血糖，1-h PG；负荷后2小时血糖，2-h PG；以及1-h PG≥8.6 mmol/L）。将孕早期血浆中TMAO及其前体的浓度分为四分位数组（底部，Q1；中间，Q2和Q3；顶部，Q4）。
在研究对象中，发现167人（17.8%）患有GDM。在调整潜在协变量后，与参考组（中间四分位数）相比，左旋肉碱浓度较低的组（Q1）患GDM的风险更高。左旋肉碱的OR（95%CI，p）为1.56（1.04，2.35，=0.032）。具体而言，这种关联主要源于左旋肉碱和异常的1-h PG。OR（95%CI，p）为2.00（1.24，3.24，=0.005）。
孕早期血浆左旋肉碱水平较低（底部四分位数与中间四分位数相比）与中国孕妇患GDM及异常1-h PG的风险较高有关。
