Relationship between changes of gut microbes and metabolite levels and insulin resistance in patients with gestational diabetes mellitus at different stages of pregnancy

doi:10.11958/20221614

Abstract

Abstract:

Objective To investigate changes of gut microbes and metabolites in patients with gestational diabetes mellitus (GDM) at different stages of pregnancy, and their relationship with insulin resistance (IR). Methods A total of 120 pregnant women with GDM who underwent prenatal examination in Anqing First People's Hospital affiliated to Anhui Medical University and plan to produce in this hospital were included in this study. Fecal samples in the first, second and third trimester of pregnancy were collected respectively. 16S rRNA method was used to determine the distribution of biological flora and to analyze the intestinal microbial situation. Liquid chromatography-tandem mass spectrometry was used to detect trimethylamine oxide (TMAO) and related metabolites in fecal samples. Insulin resistance index (HOMA-IR) was calculated sing steady-state model, and steady-state model β cell function index (HOMA-β) was evaluated. Changes of intestinal microorganism and metabolite levels in different pregnancy stages and their relationship with insulin resistance were analyzed. Results The abundance of Bacteroides and Faecalibacterium decreased in order, while the abundance of Firmicutes and Actinobacteria increased in order from the first trimester, the second trimester to the third trimester (P<0.05). TMAO, TMA and HOMA-IR increased in order, while HOMA-beta decreased in order from the first trimester, the second trimester to the third trimester (P<0.05). In the third trimester of pregnancy, Bacteroides and Faecalibacterium were negatively correlated with HOMA-IR and positively correlated with HOMA-β (P<0.05). Firmicutes, Actinomycetes, TMAO and TMA were positively correlated with HOMA-IR and negatively correlated with HOMA-β (P<0.05). Conclusion With the progress of pregnancy, the disturbance of intestinal microorganisms and metabolites in pregnant women with GDM increases the risk of developing IR.

Key words: diabetes, gestational, gastrointestinal microbiome, insulin resistance, pregnancy periods

CLC Number:

R714.147

Figures/Tables 3

References 24

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孕期		拟杆菌属		普氏菌属		另枝菌属	栖粪杆菌属		考拉杆菌属
孕早期		35.25±3.64		6.11±0.63		2.43±0.22	11.69±1.42		8.47±0.85
孕中期		27.58±3.14^a		6.12±0.78		2.46±0.28	9.71±0.98^a		8.66±0.87
孕晚期		25.69±5.24^ab		6.19±0.81		2.47±0.39	6.75±0.71^ab		8.59±0.82
F		182.485^＊＊		0.412		0.094	639.242^＊＊		1.545
孕期	毛螺菌属		副杆菌属		布劳特氏菌属			厚壁菌属	放线菌属
孕早期	4.83±0.45		1.13±0.12		0.35±0.07			2.36±0.45	9.05±2.01
孕中期	4.87±0.52		1.12±0.17		0.34±0.07			3.16±0.38^a	10.36±1.58^a
孕晚期	4.92±0.71		1.15±0.18		0.33±0.07			4.17±0.48^ab	13.26±1.54^ab
F	0.749		1.110		2.449			513.03^＊＊	187.583^＊＊

孕期		拟杆菌属		普氏菌属		另枝菌属	栖粪杆菌属		考拉杆菌属
孕早期		35.25±3.64		6.11±0.63		2.43±0.22	11.69±1.42		8.47±0.85
孕中期		27.58±3.14^a		6.12±0.78		2.46±0.28	9.71±0.98^a		8.66±0.87
孕晚期		25.69±5.24^ab		6.19±0.81		2.47±0.39	6.75±0.71^ab		8.59±0.82
F		182.485^＊＊		0.412		0.094	639.242^＊＊		1.545
孕期	毛螺菌属		副杆菌属		布劳特氏菌属			厚壁菌属	放线菌属
孕早期	4.83±0.45		1.13±0.12		0.35±0.07			2.36±0.45	9.05±2.01
孕中期	4.87±0.52		1.12±0.17		0.34±0.07			3.16±0.38^a	10.36±1.58^a
孕晚期	4.92±0.71		1.15±0.18		0.33±0.07			4.17±0.48^ab	13.26±1.54^ab
F	0.749		1.110		2.449			513.03^＊＊	187.583^＊＊

孕期	TMAO	TMA	左旋肉碱	氯化胆碱	甜菜碱
孕早期	8.26±2.35	181.23±19.58	122.36±25.29	113.26±25.87	225.36±37.21
孕中期	10.58±2.71^a	234.16±30.15^a	120.54±27.21	120.37±25.69	226.47±38.45
孕晚期	12.36±2.54^ab	297.41±30.29^ab	127.36±26.57	119.64±29.33	231.36±35.47
F	78.768^＊＊	551.159^＊＊	2.152	2.515	0.890

孕期	TMAO	TMA	左旋肉碱	氯化胆碱	甜菜碱
孕早期	8.26±2.35	181.23±19.58	122.36±25.29	113.26±25.87	225.36±37.21
孕中期	10.58±2.71^a	234.16±30.15^a	120.54±27.21	120.37±25.69	226.47±38.45
孕晚期	12.36±2.54^ab	297.41±30.29^ab	127.36±26.57	119.64±29.33	231.36±35.47
F	78.768^＊＊	551.159^＊＊	2.152	2.515	0.890

孕期	HOMA-IR	HOMA-β
孕早期	1.25±0.23	67.25±7.19
孕中期	1.69±0.17^a	36.54±5.44^a
孕晚期	3.58±0.39^ab	21.36±3.58^ab
F	2 358.598^＊＊	2 090.892^＊＊