Liver biomarkers, lipid metabolites, and risk of gestational diabetes mellitus in a prospective study among Chinese pregnant women

被引：31

作者：

Wu, Ping ^{[1
]}

Wang, Yi ^{[1
]}

Ye, Yi ^{[1
]}

Yang, Xue ^{[2
,3
]}

Huang, Yichao ^{[4
]}

Ye, Yixiang ^{[1
]}

Lai, Yuwei ^{[1
]}

Ouyang, Jing ^{[1
]}

Wu, Linjing ^{[1
]}

Xu, Jianguo ^{[5
]}

Yuan, Jiaying ^{[6
]}

Hu, Yayi ^{[7
,8
]}

Wang, Yi-Xin ^{[1
]}

Liu, Gang ^{[9
]}

Chen, Da ^{[10
]}

Pan, An ^{[1
]}

Pan, Xiong-Fei ^{[11
,12
,13
,14
]}

机构：

[1] Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Dept Epidemiol & Biostat,Minist Educ,Key Lab Envir, Wuhan 430030, Hubei, Peoples R China

[2] Sichuan Univ, West China Sch Publ Hlth, Dept Epidemiol & Biostat, Chengdu 610041, Sichuan, Peoples R China

[3] Sichuan Univ, West China Hosp 4, Chengdu 610041, Sichuan, Peoples R China

[4] Anhui Med Univ, Sch Publ Hlth, Dept Toxicol, Hefei 230032, Anhui, Peoples R China

[5] Shuangliu Maternal & Child Hlth Hosp, Dept Clin Labs, Chengdu 610200, Sichuan, Peoples R China

[6] Shuangliu Maternal & Child Hlth Hosp, Dept Sci & Educ, Chengdu 610200, Sichuan, Peoples R China

[7] Sichuan Univ, Dept Obstet & Gynecol, Chengdu 610041, Sichuan, Peoples R China

[8] Sichuan Univ, West China Univ Hosp 2, Key Lab Birth Defects & Related Dis Women & Childr, Minist Educ, Chengdu 610041, Peoples R China

[9] Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Dept Nutr & Food Hyg,Hubei Key Lab Food Nutr & Saf, Wuhan 430030, Hubei, Peoples R China

[10] Jinan Univ, Sch Environm, Guangdong Key Lab Environm Pollut & Hlth, Guangzhou 511436, Guangdong, Peoples R China

[11] Sichuan Univ, Sect Epidemiol & Populat Hlth, Chengdu 610041, Sichuan, Peoples R China

[12] Sichuan Univ, Dept Obstet & Gynecol, Key Lab Birth Defects & Related Dis Women & Childr, Minist Educ, Chengdu 610041, Sichuan, Peoples R China

[13] Sichuan Univ, West China Univ Hosp 2, Natl Med Prod Adm Key Lab Tech Res Drug Prod In Vi, Chengdu 610041, Sichuan, Peoples R China

[14] Shuangliu Maternal & Child Hlth Hosp, Shuangliu Inst Womens & Childrens Hlth, Chengdu 610041, Sichuan, Peoples R China

来源：

BMC MEDICINE | 2023年 / 21卷 / 01期

基金：

中国国家自然科学基金;

关键词：

Hepatic steatosis index; Liver enzyme; Gestational diabetes mellitus; Lipidomics; Birth cohort; INSULIN-RESISTANCE; DISEASE; ASSOCIATION; PREDICTION; STEATOSIS; DIAGNOSIS;

D O I：

10.1186/s12916-023-02818-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundLiver plays an important role in maintaining glucose homeostasis. We aimed to examine the associations of liver enzymes and hepatic steatosis index (HSI, a reliable biomarker for non-alcoholic fatty liver disease) in early pregnancy with subsequent GDM risk, as well as the potential mediation effects of lipid metabolites on the association between HSI and GDM.MethodsIn a birth cohort, liver enzymes were measured in early pregnancy (6-15 gestational weeks, mean 10) among 6,860 Chinese women. Multivariable logistic regression was performed to examine the association between liver biomarkers and risk of GDM. Pearson partial correlation and least absolute shrinkage and selection operator (LASSO) regression were conducted to identify lipid metabolites that were significantly associated with HSI in a subset of 948 women. Mediation analyses were performed to estimate the mediating roles of lipid metabolites on the association of HSI with GDM.ResultsLiver enzymes and HSI were associated with higher risks of GDM after adjustment for potential confounders, with ORs ranging from 1.42 to 2.24 for extreme-quartile comparisons (false discovery rate-adjusted P-trend <= 0.005). On the natural log scale, each SD increment of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, and HSI was associated with a 1.15-fold (95% CI: 1.05, 1.26), 1.10-fold (1.01, 1.20), 1.21-fold (1.10, 1.32), 1.15-fold (1.04, 1.27), and 1.33-fold (1.18, 1.51) increased risk of GDM, respectively. Pearson partial correlation and LASSO regression identified 15 specific lipid metabolites in relation to HSI. Up to 52.6% of the association between HSI and GDM risk was attributed to the indirect effect of the HSI-related lipid score composed of lipid metabolites predominantly from phospholipids (e.g., lysophosphatidylcholine and ceramides) and triacylglycerol.ConclusionsElevated liver enzymes and HSI in early pregnancy, even within a normal range, were associated with higher risks of GDM among Chinese pregnant women. The association of HSI with GDM was largely mediated by altered lipid metabolism.

引用

页数：12

共 43 条

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