Maternal Plasma Betaine in Middle Pregnancy Was Associated with Decreased Risk of GDM in Twin Pregnancy: A Cohort Study

Gong, Xiaoli; Du, Yufeng; Li, Xiaona; Yang, Jing; Zhang, Mengjie; Wei, Yuan; Zhao, Yangyu

doi:10.2147/dmso.s312334

Cited by 8 publications

(6 citation statements)

References 34 publications

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“…Several one-carbon metabolites have been implicated in risk for GDM. Specifically, increasing concentrations of circulating folate [ 7 , 11 , 14 , 15 , 16 ] and homocysteine [ 113 , 120 , 121 , 122 , 127 ], and decreasing vitamin B12 [ 14 , 15 , 111 , 112 , 115 ] and betaine [ 175 , 176 , 177 ] associate with increased GDM risk. Excess intake of FA has emerged as a key risk factor in GDM development.…”

Section: Discussionmentioning

confidence: 99%

“…In a prospective cohort study ( n = 486), maternal plasma betaine (≤200 nmol/mL) in early pregnancy (median: 10 weeks’ gestation, IQR: 9–11) was associated with increased GDM risk (OR: 5.00 95% CI: 2.76–9.07) [ 175 ]. Similarly, in a cohort study of dichorionic twin pregnancies ( n = 187), plasma betaine had an inverse relationship with GDM risk ( p trend = 0.015) [ 176 ].…”

Section: Association Between One-carbon Metabolism Players and Gdmmentioning

confidence: 99%

“…The role of choline and betaine in GDM development has been understudied, a summary of existing research is provided in Table 4 . Two studies report a protective role of maternal betaine in GDM [ 175 , 176 ]. In a prospective cohort study ( n = 486), maternal plasma betaine (≤200 nmol/mL) in early pregnancy (median: 10 weeks’ gestation, IQR: 9–11) was associated with increased GDM risk (OR: 5.00 95% CI: 2.76–9.07) [ 175 ].…”

Section: Association Between One-carbon Metabolism Players and Gdmmentioning

confidence: 99%

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High Folate, Perturbed One-Carbon Metabolism and Gestational Diabetes Mellitus

et al. 2022

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Folate is a dietary micronutrient essential to one-carbon metabolism. The World Health Organisation recommends folic acid (FA) supplementation pre-conception and in early pregnancy to reduce the risk of fetal neural tube defects (NTDs). Subsequently, many countries (~92) have mandatory FA fortification policies, as well as recommendations for periconceptional FA supplementation. Mandatory fortification initiatives have been largely successful in reducing the incidence of NTDs. However, humans have limited capacity to incorporate FA into the one-carbon metabolic pathway, resulting in the increasingly ubiquitous presence of circulating unmetabolised folic acid (uFA). Excess FA intake has emerged as a risk factor in gestational diabetes mellitus (GDM). Several other one-carbon metabolism components (vitamin B12, homocysteine and choline-derived betaine) are also closely entwined with GDM risk, suggesting a role for one-carbon metabolism in GDM pathogenesis. There is growing evidence from in vitro and animal studies suggesting a role for excess FA in dysregulation of one-carbon metabolism. Specifically, high levels of FA reduce methylenetetrahydrofolate reductase (MTHFR) activity, dysregulate the balance of thymidylate synthase (TS) and methionine synthase (MTR) activity, and elevate homocysteine. High homocysteine is associated with increased oxidative stress and trophoblast apoptosis and reduced human chorionic gonadotrophin (hCG) secretion and pancreatic β-cell function. While the relationship between high FA, perturbed one-carbon metabolism and GDM pathogenesis is not yet fully understood, here we summarise the current state of knowledge. Given rising rates of GDM, now estimated to be 14% globally, and widespread FA food fortification, further research is urgently needed to elucidate the mechanisms which underpin GDM pathogenesis.

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Section: Discussionmentioning

confidence: 99%

Section: Association Between One-carbon Metabolism Players and Gdmmentioning

confidence: 99%

Section: Association Between One-carbon Metabolism Players and Gdmmentioning

confidence: 99%

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High Folate, Perturbed One-Carbon Metabolism and Gestational Diabetes Mellitus

et al. 2022

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“…Mothers with high plasma choline concentrations were shown to have a lower risk of these complications, but the results were not statistically significant. On the contrary, in a study [ 73 ] of women with twin pregnancies, they found no effect of maternal choline levels on the risk of GDM.…”

Section: Maternal Choline Deficiency and Adverse Pregnancy Outcomesmentioning

confidence: 81%

Choline—An Underappreciated Component of a Mother-to-Be’s Diet

Dymek,

Oleksy,

Stolarczyk

et al. 2024

Nutrients

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The nutritional status of the mother-to-be has a key impact on the proper development of the fetus. Although all nutrients are important for the developing baby, recent research indicates the importance of adequate choline intake during the periconceptional period, pregnancy, and lactation. Choline plays a key role in the biosynthesis of cell membranes, supporting liver function, neurotransmission, brain development, and DNA and histone methylation. Choline participates in the formation of a child’s nervous system, supports its cognitive development, and reduces the risk of neural tube defects. The human body is incapable of producing sufficient choline to meet its needs; therefore, it must be obtained from the diet. Current data indicate that most women in their reproductive years do not achieve the recommended daily intake of choline. The presented narrative review indicates the importance of educating mothers-to-be and thereby increasing their awareness of the effects of choline on maternal and child health, which can lead to a more aware and healthy pregnancy and proper child development.

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“…Sample preparation was conducted according to our previous study (Gong et al, 2021 ). Briefly, 50 μL of plasma was added into 30 μL of 0.1 M dithiothreitol, vortexed for 5 min, and then incubated for 10 min at room temperature.…”

Section: Methodsmentioning

confidence: 99%

Relationship between one‐carbon metabolism and fetal growth in twins: A cohort study

Gong,

Li,

et al. 2023

Food Science & Nutrition

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We investigated the associations of one‐carbon metabolism (OCM)‐related metabolites, including choline, betaine, dimethylglycine (DMG), and methionine with fetal growth of twins. This hospital‐based cohort study included dichorionic twin gestations. Blood samples were collected at a median of 14.7 weeks of gestation. Blood plasma metabolite levels were measured using high‐performance liquid chromatography–triple quadrupole mass spectrometry. Generalized estimating equations and mixed effects models were used to explore associations between plasma metabolite levels and fetal growth. In total, 115 women with dichorionic diamniotic pregnancies were included. The maternal plasma DMG level was negatively correlated with fetal birth weight (β = −43.5, 95% confidence interval [CI] = −74.1 to −12.8, p < .05) and head circumference (β = −0.23, 95% CI = −0.39 to −0.07, p < .05). Other metabolites were not significantly associated with birth weight, body length, head circumference (HC), or chest circumference. Analysis of the relationships between plasma metabolite levels and fetal biological parameters on ultrasound revealed that the maternal choline level was negatively correlated with fetal abdominal circumference (AC) (β = −0.12, 95% CI = 0.24 to −0.004, p < .05); the maternal DMG level was negatively correlated with fetal AC (β = −0.17, 95% CI = 0.28–0.07, p < .05), femur length (β = 0.02, 95% CI = 0.04–0.003, p < .05), and estimated fetal weight (β = 26.4, 95% CI = −41.6 to −11.2, p < .05), but not with HC. The maternal methionine level was negatively correlated with HC (β = −0.08, 95% CI = −0.14 to −0.02, p < .05). The plasma level of the OCM‐related metabolite DMG during the second trimester was negatively correlated with fetal intrauterine growth and birth weight. However, further studies with larger samples are needed.

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Maternal Plasma Betaine in Middle Pregnancy Was Associated with Decreased Risk of GDM in Twin Pregnancy: A Cohort Study

Cited by 8 publications

References 34 publications

High Folate, Perturbed One-Carbon Metabolism and Gestational Diabetes Mellitus

High Folate, Perturbed One-Carbon Metabolism and Gestational Diabetes Mellitus

Choline—An Underappreciated Component of a Mother-to-Be’s Diet

Relationship between one‐carbon metabolism and fetal growth in twins: A cohort study

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