Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus

Liu, Chaoqun; Zhong, Chunrong; Zhou, Xian; Chen, Renjuan; Wu, Jiangyue; Wang, Weiye; Li, Xiating; Ding, Huisi; Guo, Yanfang; Gao, Qin; Hu, Xingwen; Xiong, Guoping; Yang, Xuefeng; Hao, Liping; Xiao, Mei; Yang, Nianhong

doi:10.1007/s12020-016-1103-6

Cited by 17 publications

(9 citation statements)

References 44 publications

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“…To clarify the temporal relation of the association between plasma TMAO and odds of GDM, we conducted a nested case-control study within an ongoing prospective cohort study, namely the Tongji Maternal and Child Health Cohort (TMCHC). The TMCHC was designed to investigate maternal dietary and lifestyle effects on the outcomes of both mothers and their offspring in Wuhan, China (22). Briefly, 8649 women who received prenatal care before 16 wk of gestation were recruited between January 2013 and May 2016.…”

Section: Study Population and Designmentioning

confidence: 99%

Plasma concentration of trimethylamine-N-oxide and risk of gestational diabetes mellitus

Zhong

et al. 2018

The American Journal of Clinical Nutrition

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Background The microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) has been reported as a novel and independent risk factor for the development of cardiovascular and metabolic diseases, but the association with gestational diabetes mellitus (GDM) remains unclear. Objective The aim of this study was to investigate the association between plasma TMAO concentration and GDM in a 2-phase study. Design A 2-phase design was used in the current study. An initial phase included 866 participants (433 GDM cases and 433 matched controls) with fasting blood samples collected at the time of GDM screening (24–32 wk of gestation). An independent-phase study, with 276 GDM cases and 552 matched controls who provided fasting blood samples before 20 wk of gestation and who had GDM screened during 24–32 wk of gestation, was nested within a prospective cohort study. These 2 studies were both conducted in Wuhan, China, and the incidence of GDM in the cohort study was 10.8%. Plasma TMAO concentrations were determined by stable isotope dilution liquid chromatography–tandem mass spectrometry. GDM was diagnosed according to the American Diabetes Association criteria by using an oral-glucose-tolerance test. Results In the initial case-control study, the adjusted OR of GDM comparing the highest TMAO quartile with the lowest quartile was 1.94 (95% CI: 1.28, 2.93). Each SD increment of ln-transformed plasma TMAO was associated with 22% (95% CI: 5%, 41%) higher odds of GDM. In the nested case-control study, women in the highest quartile also had increased odds of GDM (adjusted OR: 2.06; 95% CI: 1.28, 3.31) compared with women in the lowest quartile, and the adjusted OR for GDM per SD increment of ln-transformed plasma TMAO was 1.26 (95% CI: 1.08, 1.47). Conclusions Consistent findings from this 2-phase study indicate a positive association between plasma TMAO concentrations and GDM. Future studies are warranted to elucidate the underlying mechanisms. This trial was registered at www.clinicaltrials.gov as NCT03415295.

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Section: Study Population and Designmentioning

confidence: 99%

Plasma concentration of trimethylamine-N-oxide and risk of gestational diabetes mellitus

Zhong

et al. 2018

The American Journal of Clinical Nutrition

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“…Smoking status included active and passive smoking. Drinking alcohol more than three times a week was regarded as having a history of alcohol consumption . In our study population, no one reported a history of alcohol consumption.…”

Section: Methodsmentioning

confidence: 93%

Association between Arsenic Methylation in Early Pregnancy and Gestational Diabetes Mellitus: A Prospective Cohort Study

Jiang,

Ma,

Zheng

et al. 2023

Environ. Health

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The metabolism of arsenic (As) plays a crucial role in its health effects. However, the impact of arsenic methylation during early pregnancy on gestational diabetes mellitus (GDM) remains unclear. This study aimed to investigate the associations between As methylation in the first and second trimesters and the incidence of GDM by conducting a prospective cohort study in Chongqing, China. Urine samples from first (n = 131) and second (n = 53) trimester pregnant women were analyzed for arsenite (As III ), arsenate (As V ), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) concentrations. Logistic regressions assessed associations between the concentrations of As species, methylation indices, and GDM risk. As species concentrations showed no significant differences between GDM and non-GDM groups. Higher MMA% (OR = 1.11; 95% CI = 1.02, 1.22) and lower secondary methylation index (SMI) (OR = 0.81; 95% CI = 0.71, 0.93) correlated with GDM risk, primarily in the first trimester. MMA% decreased and DMA% and SMI increased from the first to the second trimester. Results of stratified analyses revealed these associations in women under 28 or with normal BMIs (18−24 kg/m 2 ). The study underscores inefficient arsenic methylation as a GDM risk, modified by age and BMI, with the first trimester as a critical period.

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“…However, the effect of hypobilirubinemia on GDM is controversial. Liu et al reported that higher direct bilirubin concentration was associated with a lower risk of developing GDM [21]. In contrast, other investigators could not find such an association [22,23].…”

Section: Gestational Diabetes Mellitus (Gdm)mentioning

confidence: 94%

“…First, we used only a single blood sample for measurement of the TB concentration, and plasma bilirubin concentrations are known to exhibit substantial variability within subjects [43]. Second, the bilirubin level may fluctuate during pregnancy, although there is no consensus about this fluctuation [21][22][23]. The correlation coefficients between a gestational week and TB level in NGT and GDM women were 0.214 and 0.203, respectively (Fig.…”

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confidence: 99%

Lower serum total bilirubin concentration is associated with higher prevalence of gestational diabetes mellitus in Japanese pregnant women

et al. 2018

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We aimed to clarify the pathophysiological significance of total bilirubin (TB) in gestational diabetes mellitus (GDM). This was a cross-sectional study that included 616 pregnant Japanese women (368 normal glucose tolerance [NGT] and 248 GDM). Serum TB concentration, homeostasis model assessment of insulin resistance (HOMA-IR), and other clinical parameters were compared in NGT and GDM women. TB concentration was also compared according to the number of abnormal OGTT values. Logistic regression analysis was used to evaluate the association between TB and GDM prevalence. A multiple linear regression model was used to evaluate the association between TB and HOMA-IR. TB concentrations were significantly lower in GDM women than in NGT women. This result did not change after adjustments for TB sampling timing were made. Out of 248 GDM women, the prevalences of 1-and 2/3-abnormal OGTT values (1-and 2/3-AV) GDM were 72.2% (n = 179) and 27.8% (n = 69), respectively. In the multiple comparisons, TB concentrations were significantly lower in women with 2/3-AV GDM than in women with NGT and 1-AV GDM. Multiple logistic regression analysis showed that TB was a significantly associated factor for 2/3-AV, but not for total GDM. HOMA-IR was significantly higher in GDM women than in NGT women. The univariate, but not multivariate, analysis showed that TB was a significantly associated factor for HOMA-IR. Our findings suggest that hypobilirubinemia may be involved in the pathogenesis of GDM.

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Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus

Cited by 17 publications

References 44 publications

Plasma concentration of trimethylamine-N-oxide and risk of gestational diabetes mellitus

Plasma concentration of trimethylamine-N-oxide and risk of gestational diabetes mellitus

Association between Arsenic Methylation in Early Pregnancy and Gestational Diabetes Mellitus: A Prospective Cohort Study

Lower serum total bilirubin concentration is associated with higher prevalence of gestational diabetes mellitus in Japanese pregnant women

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