Abstract
Women with gestational diabetes mellitus (GDM) have different gut microbiota in late pregnancy compared to women without GDM. It remains unclear whether alterations of gut microbiota can be identified prior to the diagnosis of GDM. This study characterized dynamic changes of gut microbiota from the first trimester (T1) to the second trimester (T2) and evaluated their relationship with later development of GDM. Compared with the control group (n = 103), the GDM group (n = 31) exhibited distinct dynamics of gut microbiota, evidenced by taxonomic, functional, and structural shifts from T1 to T2. Linear discriminant analysis (LDA) revealed that there were 10 taxa in T1 and 7 in T2 that differed in relative abundance between the GDM and control groups, including a consistent decrease in the levels of Coprococcus and Streptococcus in the GDM group. While the normoglycemic women exhibited substantial variations of gut microbiota from T1 to T2, their GDM-developing counterparts exhibited clearly reduced inter-time point shifts, as corroborated by the results of Wilcoxon signed-rank test and balance tree analysis. Moreover, cooccurrence network analysis revealed that the interbacterial interactions in the GDM group were minimal compared with those in the control group. In conclusion, lower numbers of dynamic changes in gut microbiota in the first half of pregnancy are associated with the development of GDM.IMPORTANCE GDM is one of the most common metabolic disorders during pregnancy and is associated with adverse short-term and long-term maternal and fetal outcomes. The aim of this study was to examine the connection between dynamic variations in gut microbiota and development of GDM. Whereas shifts in gut microbiota composition and function have been previously reported to be associated with GDM, very little is known regarding the early microbial changes that occur before the diagnosis of GDM. This study demonstrated that the dynamics in gut microbiota during the first half of pregnancy differed significantly between GDM and normoglycemic women. Our findings suggested that gut microbiota may potentially serve as an early biomarker for GDM.
Highlights
IMPORTANCE gestational diabetes mellitus (GDM) is one of the most common metabolic disorders during pregnancy and is associated with adverse short-term and long-term maternal and fetal outcomes
Women in the GDM group had a higher prepregnancy body mass index (BMI) and higher levels of total cholesterol (TC) and total triglyceride (TG) than the normoglycemic participants during early pregnancy, which was consistent with previous reports [18, 19]
To our knowledge, this is the first study to have demonstrated that women who develop GDM in late gestation exhibit distinct dynamics of gut microbiota from early to midgestation
Summary
IMPORTANCE GDM is one of the most common metabolic disorders during pregnancy and is associated with adverse short-term and long-term maternal and fetal outcomes. Another study demonstrated that dysbiosis (perturbation of healthy states) in gut microbiota was found in GDM women during late pregnancy and 8 months postpartum which resembled the aberrant microbiota composition in patients with type 2 diabetes [14]. These findings indicated that shifts in gut microbiota may be associated with GDM. Prominent changes in the enteric microbial community through different trimesters likely represent an intrinsic property of normal pregnancy [12] These alterations in gut microbiota occur along with metabolic changes during normal pregnancy, including an increase in endogenous glucose production and a decrease in insulin sensitivity by late gestation [15]. The aim of this study was to investigate the association between variations in gut microbiota during the 1st and 2nd trimesters and development of GDM
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