Differences in Maternal Circulating Fatty Acid Composition and Dietary Fat Intake in Women With Gestational Diabetes Mellitus or Mild Gestational Hyperglycemia

Abstract

OBJECTIVEWe investigated the relationship between maternal circulating fatty acids (FAs) and dietary FA intake in pregnant women with gestational diabetes mellitus (GDM; n = 49), women with hyperglycemia less severe than GDM (impaired glucose challenge test [GCT] non-GDM; n = 80), and normal control subjects (n = 98).RESEARCH DESIGN AND METHODSA case-control design was nested within a prospective cohort of healthy pregnant women. Fasting concentrations of serum total FAs (enzymatic assay) and FA composition (gas chromatography–mass spectrometry) were determined at entry and the third trimester. Dietary fat intake data were obtained from 24-h recalls.RESULTSThere was a graded increase among groups (control subjects, impaired GCT non-GDM, and GDM) during the third trimester for total FAs and individual FAs, including myristic, palmitic, palmitoleic, oleic, linoleic, linolenic, arachidonic, eicosapentaenoic, and docosahexaenoic acids (P for trend <0.03 to P < 0.001). Similar relationships were observed at entry in total FAs and for four FAs (myristic, palmitic, palmitoleic, and eicosapentaenoic acids). Women with impaired GCT non-GDM with BMI ≥25 kg/m2 had the highest levels of FAs at entry, whereas women with GDM with BMI ≥25 kg/m2 had the highest levels during the third trimester, and all grouped FAs were significantly different from lean women with impaired GCT non-GDM or control subjects (P < 0.05). Dietary intake of polyunsaturated FAs was decreased, but saturated FAs were increased in GDM compared with impaired GCT non-GDM or control subjects (P < 0.05).CONCLUSIONSAbnormalities in fat metabolism are present in both GDM and impaired GCT non-GDM women. Reducing pregravid weight and altering diet might prevent the associated elevation of circulating FAs.

The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies

“…Third, studies used different diagnostic criteria for GDM, with no clear pattern emerging regarding whether a significant association could be detected using less or more strict criteria. Some studies showed a gradient in dietary intake (e.g., increasing dietary fat intake) from normal glucose tolerance to abnormal glucose tolerance and GDM (39)(40)(41), whereas other studies found an association or no association consistent with both outcomes (16,20,42). Finally, the observed associations may be explained by residual confounding from unmeasured factors in the individual studies.…”

Effect of oleic acid supplementation on prostaglandin production in maternal endometrial and fetal allantochorion cells isolated from late gestation ewes

“…The ewe is a well-established model for studying these mechanisms [31,32]. OA is a major component of NEFAs with evidence to suggest that concentrations of OA are elevated in women with obesity and that this may contribute to complications such as pre-eclampsia and premature delivery [3,6,9]. On the other hand, OA supplementation is credited with beneficial actions on neutralising the negative effects of dietary saturated fatty acids [14,33].…”

“…Women with non-esterified fatty acids (NEFA) levels in the highest tertile were at about twice the risk of spontaneous pre-term birth than those in the lowest tertile [3]. Amongst these, oleic acid (OA, 18:1n-9) accounts for about 30% of the NEFAs circulating during pregnancy in women and up to 45% in sheep [8]: its concentration increases in women with gestational diabetes mellitus [9] and OA was the NEFA with the greatest increase (67%) associated with pre-eclampsia [6]. OA also constituted around 10% of the fatty acids present in amniotic fluid [10] and 30% of total membrane fatty acids in immortalised pregnant human myometrial cells [11].…”

First-Trimester Maternal Serum Amino Acids and Acylcarnitines Are Significant Predictors of Gestational Diabetes

“…These authors also compared fasting free fatty acid concentrations, and they found a significant difference (0.40 ± 0.33 vs. 0.52 ± 0.34, respectively, p = 0.02) [41]. Similarly, found maternal serum total fatty acids to be elevated in women with GDM when compared to controls [45]. In a study that used the data from the HAPO study, Scholtens et al (2014) showed that amino acid degradation pathways were altered in women with high FPG (>90th percentile) compared to women with low FPG (<10th percentile) at gestational weeks 24-32.…”

“…The metabolites most consistently associated with GDM were asymmetric dimethylarginine (ADMA) and NEFAs (major components of triacylglycerols) [25]. The latter have been found to be elevated in the third trimester of pregnancy [24,[39][40][41]. The inconsistency between the studies arose because they varied in several aspects, including the timing of serum sampling (early, mid, or late gestation), number of participants, fasting status, selection of metabolites, and differing glycemic control or treatment.…”