Association Between Trimethylamine-N-oxide and Gestational Diabetes Mellitus
Condition: Gestational Diabetes
MeSH terms: Diabetes, Gestational; Diabetes Mellitus
Study type: Observational

Summary: 
      Background: The microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) has been
      reported as a novel and independent risk factor for the development of cardiovascular and
      metabolic diseases, but the association with gestational diabetes mellitus (GDM) remains
      unclear.

      Objective: To investigate the association between plasma TMAO concentration and GDM in a
      two-phase study.

      Design: The initial discovery phase included 866 pregnant women (433 GDM cases and 433
      matched controls) in Wuhan China. Study participants were recruited from pregnant women who
      attended the outpatient clinics of the Department of Endocrinology, Tongji Hospital, to
      screen for GDM between August 2012 and April 2015, or pregnant women who visited the Hubei
      Maternal and Child Health Hospital or the Central Hospital of Wuhan for a routine antenatal
      checkup from May 2014 to November 2016. The inclusion criteria of participants were: age ≥ 20
      years, gestational age between 24 and 32 weeks, no history of a diagnosis of diabetes or
      gestational diabetes, and no history of receiving pharmacological treatment known to affect
      glucose metabolism. An independent replication phase study was nested within an ongoing
      prospective cohort study, namely the Tongji Maternal and Child Health Cohort (TMCHC).
      Beginning in January 2013, women receiving prenatal care prior to 16 weeks of gestation were
      invited to join the TMCHC. Exclusion criteria included pre-pregnancy diabetes, clinically
      significant neurological, endocrinological or other systemic diseases and multiple
      pregnancies. All enrolled pregnant women received a regular prenatal checkup in hospital and
      underwent an oral glucose tolerance test (OGTT) during 24-32 weeks of gestation to screen for
      GDM. 276 members who developed GDM before May 2016 and had fasting blood collected before 20
      weeks'gestation were included as cases in this analysis. Two controls were individually
      matched to each case from among women without GDM. These two studies were approved by the
      ethics committee of Tongji Medical College. All the participants gave informed written
      consent before they were included in the study. Plasma TMAO concentrations were determined by
      stable isotope dilution liquid chromatography with online electrospray ionization tandem mass
      spectrometry.
    


Intervention name(s): Plasma TMAO concentration
Intervention type(s): Other
Intervention description(s): Plasma TMAO concentrations were determined by stable isotope dilution liquid chromatography with online electrospray ionization tandem mass spectrometry on an AB SCIEX 4500 triple quadrupole mass spectrometer
Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        All the participants enrolled were Chinese women. They gave informed written consent to the
        study and did not take any medication known to affect glucose tolerance or insulin
        secretion before participation
      
Biospecimen description: 
      Maternal fasting blood samples were collected in anticoagulative tubes and centrifuged at
      3000 rpm for 5 min. Then, the plasma was separated and stored at -80°C for subsequent
      analysis of TMAO and other blood parameters.
    
Keywords: Trimethylamine-N-oxide; Gestational diabetes mellitus