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On-line Access: 2021-03-12

Received: 2020-08-18

Revision Accepted: 2021-01-03

Crosschecked: 2021-02-22

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 ORCID:

Dajing XIA

https://orcid.org/0000-0003-1645-9046

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Journal of Zhejiang University SCIENCE B 2021 Vol.22 No.3 P.223-232

http://doi.org/10.1631/jzus.B2000483


Reduced glycodeoxycholic acid levels are associated with negative clinical outcomes of gestational diabetes mellitus


Author(s):  Bo ZHU, Zhixin MA, Yuning ZHU, Lei FANG, Hong ZHANG, Hongwei KONG, Dajing XIA

Affiliation(s):  Department of Laboratorial Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China; more

Corresponding email(s):   dxia@zju.edu.cn

Key Words:  Gestational diabetes mellitus (GDM), Bile acid, Insulin resistance, &beta, -Cell compensation


Bo ZHU, Zhixin MA, Yuning ZHU, Lei FANG, Hong ZHANG, Hongwei KONG, Dajing XIA. Reduced glycodeoxycholic acid levels are associated with negative clinical outcomes of gestational diabetes mellitus[J]. Journal of Zhejiang University Science B, 2021, 22(3): 223-232.

@article{title="Reduced glycodeoxycholic acid levels are associated with negative clinical outcomes of gestational diabetes mellitus",
author="Bo ZHU, Zhixin MA, Yuning ZHU, Lei FANG, Hong ZHANG, Hongwei KONG, Dajing XIA",
journal="Journal of Zhejiang University Science B",
volume="22",
number="3",
pages="223-232",
year="2021",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2000483"
}

%0 Journal Article
%T Reduced glycodeoxycholic acid levels are associated with negative clinical outcomes of gestational diabetes mellitus
%A Bo ZHU
%A Zhixin MA
%A Yuning ZHU
%A Lei FANG
%A Hong ZHANG
%A Hongwei KONG
%A Dajing XIA
%J Journal of Zhejiang University SCIENCE B
%V 22
%N 3
%P 223-232
%@ 1673-1581
%D 2021
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2000483

TY - JOUR
T1 - Reduced glycodeoxycholic acid levels are associated with negative clinical outcomes of gestational diabetes mellitus
A1 - Bo ZHU
A1 - Zhixin MA
A1 - Yuning ZHU
A1 - Lei FANG
A1 - Hong ZHANG
A1 - Hongwei KONG
A1 - Dajing XIA
J0 - Journal of Zhejiang University Science B
VL - 22
IS - 3
SP - 223
EP - 232
%@ 1673-1581
Y1 - 2021
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B2000483


Abstract: 
gestational diabetes mellitus (GDM) is characterized by glycemia and insulin disorders. bile acids (BAs) have emerged as vital signaling molecules in glucose metabolic regulation. BA change in GDM is still unclear, which exerts great significance to illustrate the change of BAs in GDM. GDM patients and normal pregnant women were enrolled during the oral glucose tolerance test (OGTT) screening period. Fasting serums were sampled for the measurement of BAs. BA metabolism profiles were analyzed in both pregnant women with GDM and those with normal glucose tolerance (NGT). Delivery characteristics, delivery gestational age, and infant birthweight were extracted from medical records. GDM patients presented distinctive features compared with NGT patients, including higher body mass index (BMI), elevated serum glucose concentration, raised insulin (both fasting and OGTT), and increased hemoglobin A1c (HbA1c) levels. Higher homeostasis model assessment of insulin resistance (HOMA-IR) and decreased &beta;-Cell compensation (i.e., oral disposition index (DIo)) were also prevalent in this group. Total BAs (TBAs) remained stable, but glycodeoxycholic acid (GDCA) and taurodeoxycholic acid (TDCA) levels declined significantly in GDM. GDCA was inversely correlated with HOMA-IR and positively correlated with DIo. No obvious differences in clinical outcome between the GDM and NGT groups were observed. However, GDM patients with high HOMA-IR and low DIo tended to have a higher cesarean delivery rate and younger delivery gestational age. In conclusion, GDCA provides a valuable biomarker to evaluate HOMA-IR and DIo, and decreased GDCA levels predict poorer clinical outcomes for GDM.

妊娠期糖尿病患者血清中甘氨酸结合型脱氧胆酸降低与不良妊娠结局的相关性

目的:探讨胆汁酸代谢异常与妊娠期糖尿病不良妊娠结局的相关性。
创新点:首次利用高效液相色谱串联质谱(LC-MS)方法检测到妊娠期糖尿病(GDM)患者在口服糖耐量(OGTT)筛查期间血清胆汁酸谱的异常改变,通过结合差异性胆汁酸谱和GDM患者的分娩方式和分娩孕周及胎儿出生体重,以期为预测GDM所致的不良妊娠结局提供科学依据。
方法:本研究对浙江大学医学院附属妇产科医院2019年5月至2019年10月筛查到的GDM患者进行了回顾性分析,根据国际糖尿病与妊娠研究组公布的GDM诊断标准纳入OGTT筛查期间GDM患者67名,正常妊娠对照组48名。收集研究对象空腹状态及服糖后1、2小时的血清,检测血糖及胰岛素水平,计算GDM患者和对照组胰岛素抵抗指数(HOMA-IR)、胰岛细胞功能指数(HOMA-β)、胰岛素分泌指数、胰岛素敏感性指数,用胰岛素分泌指数(Stumvoll ?rst-phase estimate)×胰岛素敏感性指数计算β细胞补偿功能(DIo),同时利用LC-MS检测研究对象的空腹胆汁酸代谢谱,研究胆汁酸代谢的改变与上述指标之间的相关性。收集两组人群的临床资料包括基本资料及分娩方式、分娩孕周和胎儿出生体重,分析差异性胆汁酸与不良妊娠结局的相关性。
结论:甘氨酸结合型脱氧胆酸(GDCA)可作为评估HOMA-IR和DIo的有效指标,同时GDCA降低可提示GDM患者不良妊娠结局。

关键词:妊娠期糖尿病;胆汁酸;胰岛素抵抗;β细胞补偿功能

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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