Declined Maternal GDCA is Correlated With Insulin Resistance and β-Cell Compensation in GDM: A Cross-Sectional Study in Chinese Pregnant Women

Abstract

BackgroundGestational diabetes mellitus (GDM) is characterized by glycemia and insulin disorders. Bile acids (Bas) have emerged as vital signaling molecules in glucose metabolic regulation. Bas change in GDM are still unclear, it exerts great significance to illustrate the change of Bas in GDM.MethodsWe organized GDM patient (n = 67) and normal pregnant women (n = 48) around the oral glucose tolerance test (OGTT) screening period, fasting serums were collected for the measurement of Bas. Clinical data were collected and Bas metabolism profiles were analyzed in the GDM and normal glucose tolerance (NGT). Delivery characteristics, delivery gestational age and infant birthweight were abstracted from medical record to illustrate the differences among the groups.ResultsGDM patients exert the distinctive features compared with NGT, including higher BMI, glucose, insulin (both fasting and OGTT) and HbA1c levels. GDM also gained higher insulin resistance index (HOMA-IR) and decreased β-cell compensation (DIo). Total bile acids (TBA) remained stable, but glycodeoxycholic acid (GDCA) and taurodeoxycholic acid (TDCA) declined significantly in GDM. GDCA was inversely correlated with HOMA-IR and positively correlated with DIo. There exists no obvious difference in clinical outcome between GDM and NGT. However, GDM patients with high HOMA-IR and low DIo are inclined to suffering higher cesarean delivery rate and earlier delivery gestational age. ConclusionsGDM with significantly increased insulin resistance and declined DIo elevated the worse clinical outcome, GDCA could be a valuable biomarker to evaluate insulin resistance and DIo in GDM.