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A higher level of total bile acid in early mid-pregnancy is associated with an increased risk of gestational diabetes mellitus: a prospective cohort study in Wuhan, China

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Abstract

Purpose

To assess the longitudinal associations between maternal total bile acid (TBA) levels during early mid-pregnancy and the subsequent risk of gestational diabetes mellitus (GDM).

Methods

In a prospective cohort study, pregnant women who were enrolled prior to gestational week 16 were followed until delivery. TBA levels were tested during weeks 14–18 of gestation. Using logistic regression, we analyzed the associations between quartiles of TBA and GDM based on a 75-g oral glucose tolerance test (OGTT) at 24–28 gestational weeks.

Results

The GDM rate was 7.9% (114/1441). The mean TBA level was higher in women with GDM than in those without GDM (2.1 ± 2.0 vs 1.5 ± 1.0 µmol/L, P = 0.000). The highest TBA level quartile (2.1–10.7 µmol/L) had a 1.78-fold (95% CI 1.01, 3.14) increased risk of GDM compared with that of the lowest quartile (0.0–0.8 µmol/L) after adjusting for pre-pregnancy body mass index (BMI), gestational, age at TBA test and other confounders. High TBA levels were involved in the fasting glucose level rather than that at 1 h and 2 h after OGTT in all participants.

Conclusions

Pregnant women with higher serum TBA levels during early mid-pregnancy have a higher risk of developing GDM. TBA may be a new risk factor for GDM.

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Acknowledgements

The authors thank the women who participated in this study and the clinics that allowed us access to their databases.

Funding

Funding was received from the National Program on Basic Research Project of China, Ministry of Science and Technology (2013FY114200 for Nianhong Yang).

Author information

Authors and Affiliations

  1. Department of Medical Laboratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China

    M. Kong & Z. Lu

  2. Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China

    C. Zhong, Q. Gao, X. Zhou, R. Chen, L. Hao, X. Yang & N. Yang

  3. Department of Obstetrics, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China

    G. Xiong

Authors
  1. M. Kong
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  2. Z. Lu
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  3. C. Zhong
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  4. Q. Gao
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  5. X. Zhou
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  6. R. Chen
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  7. G. Xiong
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  8. L. Hao
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  9. X. Yang
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  10. N. Yang
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Contributions

NHY designed the study; MK, ZXL, CRX, XZZ, RJC, GPX, XFY and LPH researched the data; and MK drafted the manuscript. All authors approved the final version of the manuscript. NHY is the guarantor of this work and thus had full access to all study data and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to N. Yang.

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The authors declare that they have no conflicts of interest.

Ethical approval

Approval was obtained from Tongji Medical College of Huazhong University of Science and Technology Committee.

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For this type of study formal consent is not required.

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Kong, M., Lu, Z., Zhong, C. et al. A higher level of total bile acid in early mid-pregnancy is associated with an increased risk of gestational diabetes mellitus: a prospective cohort study in Wuhan, China. J Endocrinol Invest 43, 1097–1103 (2020). https://doi.org/10.1007/s40618-020-01196-7

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  • DOI: https://doi.org/10.1007/s40618-020-01196-7

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