Dynamic changes in gut microbiota of women with gestational diabetes mellitus and the correlation with blood glucose, blood lipid and diet

doi:10.3969/j.issn.1674-8115.2022.09.022

Abstract

Abstract:

Objective ·To explore the changes of gut microbiota in the women with gestational diabetes mellitus (GDM) during the second to the third trimesters of pregnancy, and the correlation with dietary intake and glucose-lipid metabolism. Methods ·From June 2019 to January 2021, 78 pregnant women (30 GDM women in the GDM group and 48 healthy women in the control group) in the second trimester of pregnancy were recruited from the Department of Obstetrics and Gynecology of Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine. Demographic information and blood biochemical indicators of the two groups were collected and analyzed. A semi-quantified Food-Frequency Questionnaire (FFQ) was used to compare the dietary intake of the two groups of pregnant women. Fecal samples were collected in both groups at the second and the third trimesters of pregnancy, respectively. The characteristics and similarities of gut microbiota in both groups at the second and the third trimesters were compared by 16S rRNA high-throughput sequencing. Spearman correlation heatmap was used to analyze the relation between the abundance of gut microbiota and environmental factors (blood biochemical indicators and dietary intake components) in the pregnant women at the second trimester. Results ·Compared with the control group, the women in the GDM group gained more weight during pregnancy (P=0.012). In the second trimester, compared with the control group, the fast blood glucose level, the blood glucose level at oral glucose tolerance test (OGTT) 1 h and 2 h, and the triacylglycerol level of the pregnant women in the GDM group were higher, and the high-density lipoprotein and the low-density lipoprotein levels were lower (all P<0.05). The results of dietary intake during pregnancy showed that the fat intake level of the pregnant women in the GDM group was higher than that in the control group (P=0.046). From the second to the third trimester of pregnancy, there was no significant difference in the α-diversity and β-diversity of gut microbiota between the GDM group and the control group. The gut bacterial composition at genus level of the GDM group at the second trimester had the least similarity with that of the other three groups (GDM group at the third trimester, control group at the second trimester and the third trimester), while the GDM group and control group had the most similar gut bacterial composition at genus level in the third trimester. Spearman correlation heatmap analysis showed that the abundance of Butyricicoccaceae was positively correlated with dietary fiber and vegetable intake level (r=0.365, P=0.024; r=0.469, P=0.003), the abundance of Klebsiella was positively correlated with triacylglycerol level (r=0.329, P=0.044), and the abundance of Bifidobacterium was negatively correlated with blood glucose level at OGTT 2 h (r=-0.364, P=0.025). Conclusion ·The composition of gut microbiota of pregnant women in the GDM group and control group in the second trimester of pregnancy is significantly different from that in the third trimester of pregnancy. The disorder of gut microbiota related to GDM in the second trimester of pregnancy may be related to glucose-lipid metabolism, dietary fat and vegetable intake level.

Key words: gestational diabetes mellitus (GDM), gut microbiota, diet, glucose-lipid metabolism

CLC Number:

R459.3

WANG Jie, WU Hui, LU Lingpeng, YANG Kefeng, ZHU Jie, ZHOU Hengyi, YAO Die, GAO Ya, FENG Yuting, LIU Yuhong, JIA Jie. Dynamic changes in gut microbiota of women with gestational diabetes mellitus and the correlation with blood glucose, blood lipid and diet[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(9): 1336-1346.

Figures/Tables 8

TrendMD

References 26

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Item	GDM group （n=30）	Control group （n=48）	P value
Age/year	29.90±4.21	28.90±4.15	0.304
Pre-pregnancy BMI/（kg·m^-2）	23.01 （20.36， 24.92）	21.20 （19.31， 23，73）	0.216
Weight gain/kg	15.74±4.80	12.63±5.77	0.012
Gravidity/n （%）			0.777
1	14 （46.67）	24 （50.00）
2	7 （23.33）	13 （27.08）
≥3	9 （30.00）	11 （22.92）
Parity/n （%）			0.277
Nulliparous	15 （50.00）	30 （62.50）
Multiparous	15 （50.00）	18 （37.50）
Educational background/n （%）			0.901
Middle school or below	5 （16.67）	7 （14.58）
High school	6 （20.00）	8 （16.67）
College	17 （56.67）	31 （64.58）
Graduate or above	2 （6.67）	2 （4.17）
FBG/（mmol·L^-1）	5.00±0.57	4.35±0.22	0.000
Blood glucose level at OGTT/（mmol·L^-1）
1 h	10.01±1.62	7.29±1.41	0.000
2 h	7.75±1.80	6.07±0.90	0.000
TC/（mmol·L^-1）	5.27±0.85	5.54±1.03	0.239
TAG/（mmol·L^-1）	3.00±1.32	2.12±0.67	0.003
HDL/（mmol·L^-1）	1.83±0.28	2.00±0.28	0.014
LDL/（mmol·L^-1）	2.67±0.65	3.07±0.90	0.040

Item	GDM group （n=30）	Control group （n=48）	P value
Age/year	29.90±4.21	28.90±4.15	0.304
Pre-pregnancy BMI/（kg·m^-2）	23.01 （20.36， 24.92）	21.20 （19.31， 23，73）	0.216
Weight gain/kg	15.74±4.80	12.63±5.77	0.012
Gravidity/n （%）			0.777
1	14 （46.67）	24 （50.00）
2	7 （23.33）	13 （27.08）
≥3	9 （30.00）	11 （22.92）
Parity/n （%）			0.277
Nulliparous	15 （50.00）	30 （62.50）
Multiparous	15 （50.00）	18 （37.50）
Educational background/n （%）			0.901
Middle school or below	5 （16.67）	7 （14.58）
High school	6 （20.00）	8 （16.67）
College	17 （56.67）	31 （64.58）
Graduate or above	2 （6.67）	2 （4.17）
FBG/（mmol·L^-1）	5.00±0.57	4.35±0.22	0.000
Blood glucose level at OGTT/（mmol·L^-1）
1 h	10.01±1.62	7.29±1.41	0.000
2 h	7.75±1.80	6.07±0.90	0.000
TC/（mmol·L^-1）	5.27±0.85	5.54±1.03	0.239
TAG/（mmol·L^-1）	3.00±1.32	2.12±0.67	0.003
HDL/（mmol·L^-1）	1.83±0.28	2.00±0.28	0.014
LDL/（mmol·L^-1）	2.67±0.65	3.07±0.90	0.040

Item	GDM group （n=30）	Control group （n=48）	P value
Nutrient intake
Energy/（J·d^-1）	6 425 408.09 （5 415 822.49， 8 290 414.36）	6 510 632.03 （5 251 444.09， 7 870 154.84）	0.475
Protein/（g·d^-1）	59.20 （51.30， 77.50）	59.70 （47.15， 71.60）	0.853
Fat/（g·d^-1）	49.40 （34.50， 55.10）	34.90 （26.10， 47.10）	0.046
Carbohydrate/（g·d^-1）	197.40 （178.10， 268.00）	211.80 （184.20， 249.20）	0.951
Fiber/（g·d^-1）	16.60 （14.40， 21.70）	17.00 （13.20， 21.80）	0.622
BCAA/（mg·d^-1）	6 340.50 （5 417.60， 7 442.50）	5 952.00 （4 212.35， 7 364.00）	0.983
PUFA/（g·d^-1）	6.90 （2.50， 8.90）	4.30 （2.70， 6.80）	0.363
MUFA/（g·d^-1）	5.70 （4.30， 7.90）	4.90 （3.10， 7.30）	0.317
SFA/（g·d^-1）	7.60 （5.50， 8.60）	7.20 （5.65， 8.70）	0.914
Food intake/（g·d^-1）
Staple	165.40 （140.70， 196.20）	179.00 （128.60， 251.25）	0.593
Vegetable	437.60 （335.90， 779.00）	639.30 （445.80， 819.10）	0.072
Fruit	506.70 （394.80， 628.60）	437.10 （294.30， 646.40）	0.319
Egg	60.00 （30.00， 64.00）	60.00 （38.60， 90.00）	0.374
Meat	50.10 （34.30， 67.10）	35.70 （21.50， 56.00）	0.111
Fish	41.40 （13.00， 78.60）	42.90 （28.25， 78.60）	0.583
Bean	77.70 （21.40， 131.40）	50.00 （22.60， 97.60）	0.655
Dairy	271.40 （200.00， 320.00）	250.00 （188.00， 305.95）	0.701
Dried fruit	16.00 （6.40， 30.00）	14.30 （3.80， 20.00）	0.318

Item	GDM group （n=30）	Control group （n=48）	P value
Nutrient intake
Energy/（J·d^-1）	6 425 408.09 （5 415 822.49， 8 290 414.36）	6 510 632.03 （5 251 444.09， 7 870 154.84）	0.475
Protein/（g·d^-1）	59.20 （51.30， 77.50）	59.70 （47.15， 71.60）	0.853
Fat/（g·d^-1）	49.40 （34.50， 55.10）	34.90 （26.10， 47.10）	0.046
Carbohydrate/（g·d^-1）	197.40 （178.10， 268.00）	211.80 （184.20， 249.20）	0.951
Fiber/（g·d^-1）	16.60 （14.40， 21.70）	17.00 （13.20， 21.80）	0.622
BCAA/（mg·d^-1）	6 340.50 （5 417.60， 7 442.50）	5 952.00 （4 212.35， 7 364.00）	0.983
PUFA/（g·d^-1）	6.90 （2.50， 8.90）	4.30 （2.70， 6.80）	0.363
MUFA/（g·d^-1）	5.70 （4.30， 7.90）	4.90 （3.10， 7.30）	0.317
SFA/（g·d^-1）	7.60 （5.50， 8.60）	7.20 （5.65， 8.70）	0.914
Food intake/（g·d^-1）
Staple	165.40 （140.70， 196.20）	179.00 （128.60， 251.25）	0.593
Vegetable	437.60 （335.90， 779.00）	639.30 （445.80， 819.10）	0.072
Fruit	506.70 （394.80， 628.60）	437.10 （294.30， 646.40）	0.319
Egg	60.00 （30.00， 64.00）	60.00 （38.60， 90.00）	0.374
Meat	50.10 （34.30， 67.10）	35.70 （21.50， 56.00）	0.111
Fish	41.40 （13.00， 78.60）	42.90 （28.25， 78.60）	0.583
Bean	77.70 （21.40， 131.40）	50.00 （22.60， 97.60）	0.655
Dairy	271.40 （200.00， 320.00）	250.00 （188.00， 305.95）	0.701
Dried fruit	16.00 （6.40， 30.00）	14.30 （3.80， 20.00）	0.318

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