Trimethylamine N-Oxide Metabolites in Early Pregnancy and Risk of Gestational Diabetes: A Nested Case-Control Study
Trimethylamine N-Oxide Metabolites in Early Pregnancy and Risk of Gestational Diabetes: A Nested Case-Control Study
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妊娠早期三甲胺 N-氧化物代谢物与妊娠糖尿病风险：巢式病例对照研究
DOI：
10.1210/jc.2019-00710
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发表时间：
2019-11-01
影响因子：
5.8
通讯作者：
Yang, Xilin
中科院分区：
文献类型：
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作者：
Huo, Xiaoxu;Li, Jing;Yang, Xilin
目的：本研究旨在探讨妊娠早期三甲基胺N-氧化物（TMAO）及其相关代谢产物与妊娠期糖尿病（GDM）风险的关系。设计：对2010年至2012年中国天津的22，302名孕妇进行前瞻性队列研究，进行巢式病例对照研究。共有243名GDM妇女和243名非GDM妇女与母亲年龄（+/- 1岁）相匹配，分别作为病例和对照。条件Logistic回归和限制性三次样条被用来检查在第一次产前检查时与GDM的个体TMAO代谢物之间的全方位风险关联。三甲基胺转化率（TMA（R））定义为三甲基胺（TMA）/其前体，三甲基胺N-氧化物转化率（TMAO（R））定义为TMAO/TMA。结果：TMA（R）与GDM呈线性相关，而TMA前体和TMAO（R）与GDM呈负相关，且有明显的阈值效应，即TMA（R）和TMAO（R）之间的数学交互作用表明TMA在GDM中积累，而TMA（R）和TMAO（R）之间的数学交互作用表明TMA在GDM中积累。TMAO为16 nmol/mL，甜菜碱为200 nmol/mL，L-肉毒碱为112 nmol/mL，胆碱酯酶为110和270 nmol/mL（U形关系）。TMA（R）>0.35和TMAO（R）仅0.35的共同存在（OR = 1.71; 95% CI，0.42至6.95）或TMAO（R）
Objectives: This study aimed to investigate the associations between trimethylamine N-oxide (TMAO) and related metabolites in early pregnancy and the risk of gestational diabetes mellitus (GDM).Design: A prospective cohort of 22,302 pregnant women from 2010 to 2012 in Tianjin, China, was used to perform a nested case-control study. A total of 243 women with GDM and 243 women without GDM matched by maternal age (+/- 1 year) were used as cases and controls, respectively. Conditional logistic regression and restricted cubic spline were used to examine the full-range risk associations between individual TMAOs metabolites at the first antenatal care visit with GDM. Trimethylamine conversion ratio (TMA(R)) was defined as trimethylamine (TMA)/its precursors, and trimethylamine N-oxide conversion ratio (TMAO(R)) was defined as TMAO/TMA. An additive interaction between high TMA(R) and low TMAO(R) indicates a state of TMA accumulation, and a mathematical interaction between high TMA(R) and high TMAO R indicates accumulation of TMAO.Results: TMA was linearly associated with GDM, whereas TMA precursors and TMAO were inversely associated with GDM with clear threshold effects, i.e., 16 nmol/mL for TMAO, 200 nmol/mL for betaine, 112 nmol/mL for L-carnitine, and 110 and 270 nmol/mL for cholinechloride (a U-shaped relationship). Copresence of TMA(R) >0.35 and TMAO(R) 0.35 only (OR = 1.71; 95% CI, 0.42 to 6.95) or TMAO(R)