Associations of serum choline, betaine and trimethylamine N-oxide with gestational diabetes mellitus among Chinese pregnant women.

OBJECTIVE

Mechanistic studies indicated beneficial effects of choline and betaine on glucose homeostasis during pregnancy. However, limited human studies explored the associations of biomarkers of choline and its related metabolites with gestational diabetes mellitus (GDM) and results remained inconsistent. This study aimed to explore associations of serum choline, betaine and trimethylamine N-oxide (TMAO) with GDM odds among Han Chinese women.

RESEARCH DESIGN AND METHODS

Pregnant women with singleton gestation were enrolled during GDM screening between 24 and 28 weeks of gestation at the Seventh People's Hospital in Shanghai, China. Women with GDM cases (n=173) and non-GDM controls (healthy women without pregnancy-related complications, n=158) were enrolled. Serum metabolites were measured by ultra-high performance liquid chromatography-multiple reaction monitoring-tandem mass spectrometry method. Multivariable logistic regression analyses were used to estimate ORs and their 95% CIs for the associations of these three metabolites with likelihood of GDM.

RESULTS

Compared with the lowest tertile of serum choline and betaine, women in the highest tertile had a multivariate-adjusted OR (95% CI) for GDM odds of 0.55 (0.30, 1.00) and 0.55 (0.30, 1.00), respectively. No significant association was found between serum TMAO and GDM odds. In addition, the stratified analysis results showed that among women with abnormal weight gain during pregnancy, there was a significant inverse association between serum betaine and GDM odds [OR (95% CI), 0.26 (0.13, 0.57)].

CONCLUSION

Serum choline and betaine, but not TMAO, tend to be inversely associated with GDM odds among Han Chinese women with singleton gestation. Especially among those women with abnormal weight gain during pregnancy, higher serum betaine was associated with lower GDM likelihood.