Background Plasma phospholipid fatty acids (FAs) in early and mid-pregnancy have been prospectively related to gestational diabetes mellitus (GDM) risk. Yet, changes of FAs following GDM diagnosis and treatment and their implications for glucose metabolism and control remain understudied. Methods From the Eunice Kennedy Shriver National Institute Child Health and Human Development Fetal Growth Studies–Singleton Cohort of 2802 pregnant women, we ascertained 85 GDM cases using the Carpenter and Coustan criteria and 85 non-GDM controls after exclusion. Using plasma collected before (23–31 weeks) and after GDM diagnosis (33–39 weeks), we quantified 25 saturated, poly- and monounsaturated FAs levels. We estimated the fold change of FAs before and after GDM diagnosis, using multiple linear mixed models adjusting for confounders. Results Eight FAs showed significant fold changes from the baseline values (23–31 weeks) among GDM cases as compared to women without GDM. Five FAs showed reduced fold changes [myristic acid (14:0): β: −0.22 (95% CI: −0.30, −0.14), palmitic acid (16:0): β: −0.02 (95% CI: −0.04, −0.01), cis-palmitoleic acid (16:1n7): β: −0.15 (95% CI: −0.24, −0.05), alpha-linolenic acid (18:3n3): β: −0.19 (95% CI: −0.31, −0.07], and dihomo-gamma-linoleic acid (20:3n6): β:−0.16; 95% CI: −0.21, −0.11)], whereas 3 showed increases [heptadecanoic acid (17:0): β: 0.17 (95% CI: 0.11, 0.22), cis-vaccenic acid (18:1n7): β: 0.06 (95% CI: 0.03, 0.10), and arachidonic acid (20:4n6): β: 0.10 (95% CI: 0.06, 0.13)]. Conclusions Our study identified 8 FAs with unique patterns of change before and after GDM diagnosis that differed significantly between women with and without GDM. Our findings may shed light on the role of FA metabolism in the pathophysiology and disease management and progression of GDM. Clinical Trial Registry NCT00912132

中文翻译：

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妊娠期血浆磷脂脂肪酸谱变化与妊娠期糖尿病诊治的关系

背景 妊娠早期和中期的血浆磷脂脂肪酸 (FAs) 与妊娠期糖尿病 (GDM) 风险具有前瞻性相关性。然而，GDM 诊断和治疗后 FA 的变化及其对葡萄糖代谢和控制的影响仍未得到充分研究。方法 从 Eunice Kennedy Shriver 国家研究所儿童健康和人类发育胎儿生长研究——2802 名孕妇的单例队列中，我们使用 Carpenter 和 Coustan 标准确定了 85 例 GDM 病例和排除后的 85 例非 GDM 对照。使用在 GDM 诊断之前（23-31 周）和之后（33-39 周）收集的血浆，我们量化了 25 种饱和的、多不饱和脂肪酸和单不饱和脂肪酸的水平。我们使用针对混杂因素进行调整的多个线性混合模型估计了 GDM 诊断前后 FA 的倍数变化。结果 与没有 GDM 的女性相比，8 个 FA 在 GDM 病例中显示出与基线值（23-31 周）相比显着的倍数变化。五种 FA 显示出减少的倍数变化 [肉豆蔻酸 (14:0)：β：-0.22 (95% CI：-0.30, -0.14)，棕榈酸 (16:0)：β：-0.02 (95% CI：-0.04 , -0.01), 顺式-棕榈油酸 (16:1n7): β: -0.15 (95% CI: -0.24, -0.05), α-亚麻酸 (18:3n3): β: -0.19 (95% CI: -0.31, -0.07] 和二高-γ-亚油酸 (20:3n6)：β：-0.16；95% CI：-0.21，-0.11)]，而 3 显示增加 [十七烷酸 (17:0)： β：0.17（95% CI：0.11，0.22），顺式异油酸（18:1n7）：β：0.06（95% CI：0.03，0.10），花生四烯酸（20:4n6）：β：0.10（95 % CI：0.06, 0.13)]。结论 我们的研究确定了 8 种 FA 在 GDM 诊断前后具有独特的变化模式，在患有和未患有 GDM 的女性之间存在显着差异。我们的研究结果可能有助于阐明 FA 代谢在 GDM 的病理生理学和疾病管理以及进展中的作用。临床试验注册 NCT00912132