Maternal Circulating Transthyretin Level Is Longitudinally Associated With Increased Risk of Gestational Diabetes Mellitus: It Is Not Just an Indicator of Nutritional Status

Abstract

Transthyretin (TTR) is a carrier protein that transports thyroid hormones and retinol. Conventionally, a higher serum TTR level is usually taken as a sensitive clinical indicator of better protein nutritional status (1). However, emerging evidence has given us clues that TTR may contribute to gestational diabetes mellitus (GDM) (2–5). If this is the case, our previous “good impression” of TTR might be overturned. However, few population-based studies have focused on this issue. In this prospective cohort study, we measured serum TTR, total protein (TP), albumin (Alb), and other parameter levels in the regular antenatal liver and renal function (LRF) test at 13–20 gestational weeks in 1,914 pregnant women (aged 18–45 years) belonging to the ongoing Tongji Maternal and Child Health Cohort (TMCHC) study in China. All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics review committee of Tongji Medical College of Huazhong University of Science and Technology and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Using logistic regression, we analyzed the association between …