Characteristics of the gut microbiome in women with gestational diabetes mellitus: A systematic review

Background The incidence of women developing gestational diabetes mellitus (GDM) is increasing, which is associated with an increased risk of type 2 diabetes mellitus (T2DM) for both mother and child. Gut microbiota dysbiosis may contribute to the pathogenesis of both GDM and the accompanying risk of T2DM. Thus, a better understanding of the microbial communities associated with GDM could offer a potential target for intervention and treatment in the future. Therefore, we performed a systematic review to investigate if the GDM women have a distinct gut microbiota composition compared to non-GDM women. Methods We identified 21 studies in a systematic literature search of Embase and PubMed up to February 24, 2021. Data on demographics, methodology and identified microbial metrics were extracted. The quality of each study was assessed according to the Newcastle-Ottawa Scale. Results Sixteen of the studies did find a GDM-associated gut microbiota, although no consistency could be seen. Only Collinsella and Blautia showed a tendency to be increased in GDM women, whereas the remaining genera were significantly different in opposing directions. Conclusion Although most of the studies found an association between GDM and gut microbiota dysbiosis, no overall GDM-specific gut microbiota could be identified. All studies in the second trimester found a difference between GDM and non-GDM women, indicating that dysbiosis is present at the time of diagnosis. Nevertheless, it is still unclear when the dysbiosis develops, as no consensus could be seen between the studies investigating the gut microbiota in the first trimester of pregnancy. However, studies varied widely concerning methodology and study design, which might explain the highly heterogeneous gut microbiota compositions between studies. Therefore, future studies need to include multiple time points and consider possible confounding factors such as ethnicity, pre-pregnancy body mass index, and GDM treatment.

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First Trimester Potential Biochemical Predictive Tests for Gestational Diabetes Mellitus: A Systematic Review

Iranian journal of diabetes and obesity ◽

10.18502/ijdo.v13i4.8002 ◽

2021 ◽

Author(s):

Soodabeh Darvish ◽

Farzaneh Rashidi Fakari ◽

Simin Haghdoost

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

First Trimester ◽

Predictive Tests ◽

Increased Risk ◽

Metabolic Complication ◽

Hs Crp ◽

Maternal Bmi

Objective: Gestational diabetes mellitus (GDM) is the most common metabolic complication during pregnancy. So, a large number of studies have evaluated the usefulness of different screening tests. The aim of this study was focused on the potential of only first-trimester screening used in the prediction of GDM. Materials and Methods: In this systematic review, we searched PubMed, EMBASE, and Scopus (between 2010 and 2020) and also searched the reference lists of the relevant articles manually. After performing a thorough evaluation of the 242 potentially eligible papers, only 60 papers were selected in terms of the inclusion criteria. Search key terms were combining ‘Gestational diabetes’ or ‘GD’ “gestational diabetes mellitus” or” GDM” or pregnancy-induced diabetes’ with at least one of the following terms: “screening test”, “first-trimester”, “prediction”, “marker predictor”, “serum marker”. Results: A total of 161954 pregnant women were evaluated in these reviewed studies. Moreover, many tests were assessed in the first trimester of pregnancy to predict GDM. This review showed that hs-CRP, FPG, TG, and LDL-C along with maternal BMI in the first trimester were related to the increased risk of developing GDM. Other tests were used in only one or two studies. Conclusion: This review showed that hs-CRP, FPG, TG, and LDL-C along with maternal BMI in the first trimester were linked to an increased risk of developing GDM. It is recommended that further well-designed studies by considering the cost-effective advantages of these predictive tests, should be performed.

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GUT MICROBIOTA AND GESTATIONAL DIABETES MELLITUS: A SYSTEMATIC REVIEW

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2021.109078 ◽

2021 ◽

pp. 109078

Author(s):

Patricia Medici Dualib ◽

Juliana Ogassavara ◽

Rosiane Mattar ◽

Edina Mariko Koga da Silva ◽

Sérgio Atala Dib ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Gestational Diabetes ◽

Gut Microbiota ◽

Gestational Diabetes Mellitus

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Early prediction of gestational diabetes mellitus in the Chinese population via advanced machine learning

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa899 ◽

2020 ◽

Author(s):

Yan-Ting Wu ◽

Chen-Jie Zhang ◽

Ben Willem Mol ◽

Andrew Kawai ◽

Cheng Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Machine Learning ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Chinese Population ◽

Feature Selection Method ◽

Area Under The Curve ◽

First Trimester ◽

Record System ◽

Increased Risk

Abstract Context Accurate methods for early gestational diabetes mellitus (GDM) (during the first trimester of pregnancy) prediction in Chinese and other populations are lacking. Objectives Establishing effective models to predict early GDM. Setting Pregnancy data for 73 variables during the first trimester were extracted from the electronic medical record system. Main measures Based on a machine learning (ML) driven feature selection method, 17 variables were selected for early GDM prediction. In order to facilitate clinical application, 7 variables were selected from the 17-variable panel. Advanced ML approaches were then employed using the 7-variable dataset and the 73-variable dataset to build models predicting early GDM for different situations respectively. Results 16,819 and 14,992 cases were included in the training and testing sets, respectively. Using 73 variables, the deep neural network model achieved high discriminative power, with area under the curve (AUC) values of 0.80. The 7-variable logistic regression (LR) model also achieved effective discriminate power (AUC = 0.77). Low BMI (≤ 17) was related to an increased risk of GDM, compared to a BMI in the range of 17 to 18 (minimum risk interval) (11.8% vs 8.7%, P = 0.0935). TT3 and TT4 were superior to FT3 and FT4 in predicting GDM. Lipoprotein (a) was demonstrated a promising predictive value (AUC = 0.66). Conclusions We employed ML models that achieved high accuracy in predicting GDM in early pregnancy. A clinically cost-effective 7-variable LR model was simultaneously developed. The relationship of GDM with thyroxine and BMI was investigated in the Chinese population.

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Is Gestational Diabetes Mellitus a Risk Factor of Maternal Breast Cancer? A Systematic Review of the Literature

Biomedicines ◽

10.3390/biomedicines9091174 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1174

Author(s):

Julien Simon ◽

Karine Goueslard ◽

Sonia Bechraoui-Quantin ◽

Patrick Arveux ◽

Catherine Quantin

Keyword(s):

Breast Cancer ◽

Diabetes Mellitus ◽

Systematic Review ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

English Language ◽

Low Grade ◽

Hormonal Changes ◽

Review Of The Literature ◽

Increased Risk

The association between gestational diabetes mellitus (GDM) and breast cancer (BC) risk is complex. We aimed to examine this association in a systematic review of the literature. This review was done using the PubMed/Medline and Web of Science databases, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Newcastle–Ottawa Scale was used for the assessment of bias and quality of studies. Only English-language articles published before 1 June 2021, were included. Fourteen studies were included in this systematic review. Among them, eight did not find statistically significant results. Three studies showed a statistically significant increased risk of BC after GDM, and they explained this potential increased risk by hyperinsulinemia, hyperglycemia, and low-grade inflammation. However, three studies showed a statistically significant decreased risk of BC after GDM, suggesting a possible protective effect of hormonal changes induced by GDM during pregnancy. These controversial results should be interpreted with caution due to both quantitative and qualitative methodological shortcomings. Further investigations are thus needed in order to gain a better understanding of the associations between GDM and BC, and their underlying mechanisms.

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First Trimester Metabolites Predict Gestational Diabetes Mellitus Diagnosis: A Case: Control Study (FS03-04-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz046.fs03-04-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Manuel Ramos ◽

Anna Lamb ◽

Noemi Alarcon ◽

Adilene Quintana-Diaz ◽

Rob Fanter ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Dietary Intervention ◽

Intervention Group ◽

First Trimester ◽

Case Control ◽

Plasma Metabolites ◽

Blood Draw ◽

Increased Risk

Abstract Objectives Gestational Diabetes Mellitus (GDM) has an overall prevalence estimated as high as 13% of overweight/obese (OW/OB) pregnant women. Since the occurrence of GDM can have a combination of adverse perinatal outcomes and long-term increased risk of health issues in the future for both the mother and child, it is important that the mechanisms involved in this disease are better understood so that better prevention strategies can be devised. We sought to identify early and late pregnancy metabolites that discriminated women who developed vs. did not develop GDM to provide insight into its etiology and help improve treatments. Methods Participants were 26 OW/OB women enrolled in the Healthy Beginnings Trial and completed blood draws at 13 weeks, 26 weeks, and 35 weeks gestation. Participants from the control and dietary intervention group who developed GDM (N = 12) were matched on age and study entry BMI with those who did not develop GDM (N = 14). Plasma samples were analyzed by ultra-high-performance liquid chromatography-hybrid triple‐quadrupole linear ion trap mass spectrometry (UPLC-QTRAP) using two targeted metabolomics assays for primary metabolomics and aminomics. Results A total of 142 metabolites were identified. Most metabolite differences were observed during the first trimester blood draw, prior to GDM diagnosis. At first trimester, metabolites related to energy metabolism that were altered included lower levels of alpha-ketoglutarate and glycerol-3-phosphate, as well as the medium-chain acylcarnitines’ lauroyl-carnitine, dodecenoyl-carnitine, and octanoyl-carnitine (P < 0.05). Interestingly, the neurotransmitters serotonin and glutamate were elevated in subjects who later developed GDM (P < 0.01). In regards to the observed elevated creatine, the lower concentrations of methionine and glycine may suggest utilization of these amino acids for its production (P < 0.03). Lastly, the gut microbiota-derived indole-3-propionate was higher in GDM cases (P < 0.05). In the third trimester of the GDM group, only levels of 4-pyridoxate (vitamin B-6) were lowered (P < 0.05). Conclusions Metabolic changes associated with the numerous plasma metabolites that were different between GDM case-control subjects during first trimester may predict the development of this condition. Funding Sources NIH, ARI.

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Gestational Diabetes Mellitus Is Associated with Reduced Dynamics of Gut Microbiota during the First Half of Pregnancy

mSystems ◽

10.1128/msystems.00109-20 ◽

2020 ◽

Vol 5 (2) ◽

Cited By ~ 3

Author(s):

Wei Zheng ◽

Qian Xu ◽

Wenyu Huang ◽

Qi Yan ◽

Yating Chen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gut Microbiota ◽

Gestational Diabetes Mellitus ◽

Late Pregnancy ◽

First Trimester ◽

Rank Test ◽

Control Group ◽

Dynamic Changes ◽

Linear Discriminant

ABSTRACT Women with gestational diabetes mellitus (GDM) have different gut microbiota in late pregnancy compared to women without GDM. It remains unclear whether alterations of gut microbiota can be identified prior to the diagnosis of GDM. This study characterized dynamic changes of gut microbiota from the first trimester (T1) to the second trimester (T2) and evaluated their relationship with later development of GDM. Compared with the control group (n = 103), the GDM group (n = 31) exhibited distinct dynamics of gut microbiota, evidenced by taxonomic, functional, and structural shifts from T1 to T2. Linear discriminant analysis (LDA) revealed that there were 10 taxa in T1 and 7 in T2 that differed in relative abundance between the GDM and control groups, including a consistent decrease in the levels of Coprococcus and Streptococcus in the GDM group. While the normoglycemic women exhibited substantial variations of gut microbiota from T1 to T2, their GDM-developing counterparts exhibited clearly reduced inter-time point shifts, as corroborated by the results of Wilcoxon signed-rank test and balance tree analysis. Moreover, cooccurrence network analysis revealed that the interbacterial interactions in the GDM group were minimal compared with those in the control group. In conclusion, lower numbers of dynamic changes in gut microbiota in the first half of pregnancy are associated with the development of GDM. IMPORTANCE GDM is one of the most common metabolic disorders during pregnancy and is associated with adverse short-term and long-term maternal and fetal outcomes. The aim of this study was to examine the connection between dynamic variations in gut microbiota and development of GDM. Whereas shifts in gut microbiota composition and function have been previously reported to be associated with GDM, very little is known regarding the early microbial changes that occur before the diagnosis of GDM. This study demonstrated that the dynamics in gut microbiota during the first half of pregnancy differed significantly between GDM and normoglycemic women. Our findings suggested that gut microbiota may potentially serve as an early biomarker for GDM.

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The association of first trimester high blood pressure and risk of gestational diabetes mellitus

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2012-18-1-67-72 ◽

2012 ◽

Vol 18 (1) ◽

pp. 67-72

Author(s):

P. V. Popova ◽

A. S. Gerasimov ◽

E. N. Kravchuk ◽

E. S. Shelepova ◽

E. M. Ryazantseva ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Fold Increase ◽

First Trimester ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Increased Risk ◽

First Trimester Of Pregnancy

Objective. To determine the relationship between blood pressure measured during the first trimester of pregnancy and the risk of the development of gestational diabetes mellitus. Design and methods. A total of 209 pregnant women were screened for gestational diabetes mellitus between weeks 24 and 28 of gestation, as defined by WHO criteria. Blood pressure, weight and waist circumference data were obtained by review of the medical records. Results. An elevated blood pressure at first trimester of pregnancy was associated with a six-fold increase in the risk of the development of gestational diabetes mellitus (OR = 5.8, 95 % CI 1.9-17.5, p = 0.001) compared with non-hypertensive women. Arterial hypertension (including controlled forms) in the first trimester of pregnancy was followed by a three-fold (OR = 3.04, 95 % CI 1.5-6.3) increase in the risk of gestational diabetes mellitus compared with non-hypertensive women (p = 0.005). Conclusion. Obtained data indicate that women with elevated blood pressure in the first trimester of pregnancy have an increased risk of the development of gestational diabetes mellitus.

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The Modulation of Gut Microbiota Composition in the Pathophysiology of Gestational Diabetes Mellitus: A Systematic Review

Biology ◽

10.3390/biology10101027 ◽

2021 ◽

Vol 10 (10) ◽

pp. 1027

Author(s):

Thubasni Kunasegaran ◽

Vinod R. M. T. Balasubramaniam ◽

Valliammai Jayanthi T. Arasoo ◽

Uma Devi Palanisamy ◽

Amutha Ramadas

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Gestational Diabetes ◽

Gut Microbiota ◽

Gestational Diabetes Mellitus ◽

Dietary Intervention ◽

Large Body ◽

Microbial Interactions ◽

Assessment Tools ◽

Microbial Dysbiosis

General gut microbial dysbiosis in diabetes mellitus, including gestational diabetes mellitus (GDM), has been reported in a large body of literature. However, evidence investigating the association between specific taxonomic classes and GDM is lacking. Thus, we performed a systematic review of peer-reviewed observational studies and trials conducted among women with GDM within the last ten years using standard methodology. The National Institutes of Health (NIH) quality assessment tools were used to assess the quality of the included studies. Fourteen studies investigating microbial interactions with GDM were found to be relevant and included in this review. The synthesis of literature findings demonstrates that Bacteroidetes, Proteobacteria, Firmicutes, and Actinobacteria phyla, such as Desulfovibrio, Ruminococcaceae, P. distasonis, Enterobacteriaceae, Collinsella, and Prevotella, were positively associated with GDM. In contrast, Bifidobacterium and Faecalibacterium, which produce butyrate, are negatively associated with GDM. These bacteria were associated with inflammation, adiposity, and glucose intolerance in women with GDM. Lack of good diet management demonstrated the alteration of gut microbiota and its impact on GDM glucose homeostasis. The majority of the studies were of good quality. Therefore, there is great potential to incorporate personalized medicine targeting microbiome modulation through dietary intervention in the management of GDM.

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Vitamin D status and association with gestational diabetes mellitus in a pregnant cohort in Iceland

Food & Nutrition Research ◽

10.29219/fnr.v65.5574 ◽

2021 ◽

Author(s):

Kristin S. Magnusdottir ◽

Ellen A. Tryggvadottir ◽

Ola K. Magnusdottir ◽

Laufey Hrolfsdottir ◽

Thorhallur I. Halldorsson ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

First Trimester ◽

Vitamin D Status ◽

Increased Risk ◽

Vitamin D Levels ◽

25Ohd Concentration

Background: Vitamin D deficiency has been associated with an increased risk of gestational diabetes mellitus (GDM), one of the most common pregnancy complications. The vitamin D status has never previously been studied in pregnant women in Iceland. Objective: The aim of this research study was to evaluate the vitamin D status of an Icelandic cohort of pregnant women and the association between the vitamin D status and the GDM incidence. Design: Subjects included pregnant women (n = 938) who attended their first ultrasound appointment, during gestational weeks 11–14, between October 2017 and March 2018. The use of supplements containing vitamin D over the previous 3 months, height, pre-pregnancy weight, and social status were assessed using a questionnaire, and blood samples were drawn for analyzing the serum 25‑hydroxyvitamin D (25OHD) concentration. Information regarding the incidence of GDM later in pregnancy was collected from medical records. Results: The mean ± standard deviation of the serum 25OHD (S-25OHD) concentration in this cohort was 63±24 nmol/L. The proportion of women with an S-25OHD concentration of ≥ 50 nmol/L (which is considered adequate) was 70%, whereas 25% had concentrations between 30 and 49.9 nmol/L (insufficient) and 5% had concentrations < 30 nmol/L (deficient). The majority of women (n = 766, 82%) used supplements containing vitamin D on a daily basis. A gradual decrease in the proportion of women diagnosed with GDM was reported with increasing S-25OHD concentrations, going from 17.8% in the group with S-25OHD concentrations < 30 nmol/L to 12.8% in the group with S-25OHD concentrations ≥75 nmol/L; however, the association was not significant (P for trend = 0.11). Conclusion: Approximately one-third of this cohort had S-25OHD concentrations below adequate levels (< 50 nmol/L) during the first trimester of pregnancy, which may suggest that necessary action must be taken to increase their vitamin D levels. No clear association was observed between the vitamin D status and GDM in this study.

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Beverage Intake and the Risk of Gestational Diabetes Mellitus: The SECOST

Nutrients ◽

10.3390/nu13072208 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2208

Author(s):

Heng Yaw Yong ◽

Zalilah Mohd Shariff ◽

Barakatun Nisak Mohd Yusof ◽

Zulida Rejali ◽

Yvonne Yee Siang Tee ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

First Trimester ◽

Soy Milk ◽

Second Trimester ◽

Adverse Health Outcomes ◽

Increased Risk ◽

The Mean ◽

Carbonated Drinks

The contribution and impact of beverage intake to total nutrient and energy intake may be substantial. Given the link between lifestyle, diet, and the risk of pregnancy complications, this study investigated the association between the quantity and types of beverages with gestational diabetes mellitus (GDM) risk. The study included 452 women from the Seremban Cohort Study (SECOST). The mean energy by beverage intake was 273 ± 23.83 kcal/day (pre-pregnancy), 349 ± 69.46 kcal/day (first trimester) and 361 ± 64.24 kcal/day (second trimester). Women significantly increased intake of maternal milks and malted drinks, but significantly reduced the intake of carbonated drinks and other drinks from before until the second trimester of pregnancy. For chocolate drinks, carbonated drinks, and soy milk, women increased intake from pre-conception to the first trimester, but reduced their intake from the first to the second trimester. While higher intake of cultured-milk drinks was associated with an increased risk of GDM, higher fruit juice intake was associated with a lower risk of GDM. However, these associations were only observed for intake prior to pregnancy and during the first trimester. Further research is needed to corroborate these findings and investigate the contributions of different beverages to overall diet quality as well as adverse health outcomes during pregnancy.

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