Metabolomic biomarkers and novel dietary factors associated with gestational diabetes in China

Introduction Gestational diabetes mellitus (GDM) is impaired glucose tolerance first recognised during pregnancy; its development is associated with many adverse outcomes. Mechanisms of GDM development are not fully elucidated and few studies have used Chinese participants. Objectives The aim of this study was to investigate the maternal metabolome associated with GDM in a Chinese population,and explore the relationship with maternal diet. Methods Ninety-three participants were recruited at 26–28 weeks’ gestation from Chongqing, China. Maternal urine, serum, and hair metabolomes were analysed using gas and liquid chromatography–mass spectrometry. Dietary intake was assessed using a 96-item food frequency questionnaire. Results Of the 1064 metabolites identified, 73 were significantly different between cases and controls (P<0.05), but only 2-aminobutyric acid had both a p- and q-value<0.05. A “snack-based-dietary-pattern” was associated with an increased likelihood of GDM (odds ratio 2·1; 95% confidence interval 1.1–3.9). The association remained significant after adjustment for calorie intake but not food volume. Conclusion This study provides a comprehensive characterization of the maternal metabolome. The snack-based dietary pattern associated with GDM suggests that timing and frequency of consumption are important factors in the relationship between maternal diet and GDM.