Elevated First-Trimester Total Bile Acid is Associated with the Risk of Subsequent Gestational Diabetes

Abstract

The aim of the current study is to assess whether total bile acid (TBA) level in first trimester pregnancy is associated with gestational diabetes mellitus (GDM). Biochemical parameters including serum TBA of 742 pregnant women were collected within 12 weeks of gestation and compared. At 24–28th weeks of gestation, 75 g oral glucose tolerance test (OGTT) was performed. The perinatal data of 330 women were collected. The results demonstrated women with GDM (n = 268) had higher first-trimester serum levels of TBA compared with healthy subjects (n = 474) (2.3 ± 1.4 μmol/L vs. 1.9 ± 1.0 μmol/L, P < 0.001). TBA was independently associated with GDM [adjusted odds ratio (AOR), 1.38; 95% confidence interval (CI), 1.18–1.61, P < 0.001]. Compared to the first category of TBA, women in the highest category had a marked increase in risk for GDM (AOR, 7.72; 95% CI, 3.22–18.50, P < 0.001). In conclusion, higher first-trimester TBA levels, even within normal range, may help indicate increased risk of GDM.

Risk Factors Screening for Gestational Diabetes Mellitus Heterogeneity in Chinese Pregnant Women: A Case–Control Study

“…Excessive fat accumulation before and during pregnancy also explains the association between the following risk factors and the GDM-resistance subtype. Some studies found that the elevated ALT level and dyslipidemia in the first trimester increasing the risk of GDM, 26 , 27 and the higher first-trimester serum levels of TBA is also associated with GDM, 13 , 28 however, the association between these risk factors and GDM are attenuated by overweight/obesity. 26 , 29 ALT is a cytosolic enzyme that has a relatively higher concentration in the liver.…”

Obeticholic acid ameliorates dyslipidemia but not glucose tolerance in mouse model of gestational diabetes

“…FXR expression is reduced in rodent models of both type 1 and type 2 diabetes mellitus (16), and Fxr −/− mice have elevated serum glucose concentrations and insulin resistance (9, 32, 64), as well as hypercholanemia (37, 50). A recent study found that elevated total serum bile acids in the first trimester of pregnancy was associated with increased risk of developing GDM (25). Individual bile acid species also differ between women with GDM and normal pregnancy (19).…”

Declined Maternal GDCA is Correlated With Insulin Resistance and β-Cell Compensation in GDM: A Cross-Sectional Study in Chinese Pregnant Women

“…Indeed, in Chinese prospective cohort studies, the incidence of GDM in the group with highest TBA (≥ 4.0 µM) in early pregnancy had a 6.72-fold increased risk of GDM compared with the lowest level. Even after adjusting potential confounders, TBA ≥ 2.0 µM still presented an increased risk for developing GDM [29,30]. In our research, TBA changed slightly in GDM compared with normal glucose tolerance, this may be partially caused by the difference between the TBA detected by enzymatic cycling assay and the TBA consist of 15 bile acids individuals detected mass spectrometry.…”