Gestational diabetes & diabetes in pregnancy
Metabolic pathways mediating insulin resistance and gestational diabetes mellitus discovered by high-dimensional systematic Mendelian randomization
Authors' conclusion
These results indicated that targeting specific metabolic pathways through dietary intervention is worth exploring as a possible GDM prevention approach, and hdsMR is more efficient in finding causal mediating metabolic pathways than traditional MR methods.
Study context
- Population
- Pregnant women aged >18 years at the University of Hong Kong-Shenzhen Hospital, 2015–2018, without major chronic diseases or long-term medications affecting glycolipid metabolism
- Participants
- 566 women
- Comparison
- Gestational diabetes mellitus (GDM) cases vs normal glucose tolerance controls
- GDMn = 274
- Outcome
- Causal role of HOMA-IR and metabolic pathways in the pathogenesis of GDM
Methodological detailshigh-dimensional systematic Mendelian randomization (hdsMR), case-control, single-centre
- High-dimensional systematic Mendelian randomization (hdsMR)
- Case-control
- Single-centre
Main finding
As reported in the abstract
HOMA-IR causal to GDM, OR
1.17
95% CI 1.04–1.32
Proportion mediated by glyoxylate and dicarboxylate metabolism pathway between HOMA-IR and GDM
14.6%
Proportion mediated by lysine degradation pathway between HOMA-IR and GDM
8.4%
Observational data: associations, not effects.
Further findings
Dietary intervention on both pathways in independent validation cohort
- Both pathways could be intervened through diet (P < 0.05); validation cohort of 255 pre-diabetic individuals
Glyoxylate and dicarboxylate metabolism pathway and adverse pregnancy outcomes in GDM
- Significantly associated with adverse pregnancy outcomes in GDM
Original publication
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