Circulating Linoleic Acid is Associated with Improved Glucose Tolerance in Women after Gestational Diabetes

Abstract

Women with previously diagnosed gestational diabetes mellitus (GDM) are at increased risk of type-2-diabetes mellitus (T2D). We aimed to establish links between glucose tolerance (GT) and serum fatty acid (FA) profile in the transition from GDM to T2D. Six years after GDM, 221 women were grouped as having normal GT (NGT), impaired GT (IGT), or T2D based on oral GT test results. Fasting serum FAs were profiled, anthropometric measures taken, and dietary intake determined. Linoleic acid (LA) was significantly higher in NGT women (p < 0.001) compared with IGT and T2D, and emerged as a strong predictor of low glucose and insulin levels, independently of BMI. Self-reported vegetable oil consumption correlated with LA serum levels and glucose levels. Delta-6-, delta-9-, and stearoyl-CoA-desaturase activities were associated with decreased GT, and delta-5-desaturase activities with increased GT. In a subgroup of women at high risk of diabetes, low LA and high palmitic acid levels were seen in those that developed T2D, with no differences in other FAs or metabolic measurements. Results suggest that proportions of LA and palmitic acid are of particular interest in the transition from GDM to T2D. Interconversions between individual FAs regulated by desaturases appear to be relevant to glucose metabolism.

Metabolic signatures in the conversion from gestational diabetes mellitus to postpartum abnormal glucose metabolism: a pilot study in Asian women

“…We also observed linoleic acid (LA) signatures, alpha-linoleic acid (ALA), and glycocholic acid in women with postpartum AGM. LA is a polyunsaturated fatty acid (PUFA) and a type of omega-6 fatty acid associated with reduced risk of T2D and improved glucose tolerance in women after GDM 19 , 20 . Incorporating linoleic acid into phospholipids could alter membrane fluidity and further enhance insulin receptor activity 21 .…”

Changes in Plasma Free Fatty Acids Associated with Type-2 Diabetes

“…Total n-6 FFAs, LA and ARA were also associated with lower T2DM risk in a prospective Finnish study of 2189 men [103]. Similarly, glucose tolerance was better in women after gestational diabetes where they had higher levels of LA [104]. In a study with 667 participants, LA associated with low fasting glucose in cross-sectional but not prospective analyses [105].…”

Early markers of gestational diabetes mellitus

“…The long-term implications are associated with recurrent GDM in subsequent pregnancies, T2DM, and cardiovascular diseases later in life. The short-term implications for the child include macrosomia, perinatal death, neonatal hypoglycaemia, shoulder dystocia and related birth injures, hyperbilirubinemia, and a low Apgar score ( 2 , 14 ). The long-term implications for the child are T2DM, obesity, and GDM (females only) ( 7 ).…”