ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1587863
This article is part of the Research TopicMaternal Metabolic Health: From Preconception to PostpartumView all 8 articles
Associations of First-Trimester TMAO and Its Precursors with Gestational Diabetes Mellitus: A Pilot Prospective Cohort Study
Provisionally accepted
Geng-dong Chen*
Ting-Ting Pang
Pengsheng LiShao-Xin YeXiao-Yan GouHai-Yan Wang
Dongxin Lin
Dazhi FanLu-Sha Deng*Li-Juan Wang*
Zixing Zhou*- Foshan Women and Children Hospital, Foshan, China
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We aimed to provide a comprehensive understanding of the associations between Trimethylamine-N-oxide (TMAO), its precursor and gestational diabetes mellitus (GDM).In this prospective study, 940 women were included in a Chinese single -center pregnant cohort. First trimester plasma concentrations of TMAO and its precursors (betaine, choline, L-carnitine, and trimethylamine) were measured using UPLC-ESI-MS/MS. GDM and specific abnormal glucose levels (fasting glucose;one-hour post-load glucose, 1-h PG; two-hour post load glucose, 2-h PG; and 1-h PG ≥ 8.6 mmol/L ) were assessed through oral glucose tolerance tests. First-trimester plasma concentrations of TMAO and its precursors were divided into quartile groups (bottom, Q1; middle, Q2 and Q3; top, Q4).Results: Among the subjects, 167 (17.8%) were found to have GDM. After adjusting for potential covariates, the lower groups (Q1) of L-carnitine were associated with a higher risk of GDM compared to the reference group (middle quartiles). The OR (95% CI, p) was1.56 (1.04, 2.35, p=0.032) for L-carnitine. Specifically, the associations were mainly derived from L-carnitine and abnormal 1-h PG. The ORs (95% CI, p) were 2.00 (1.24, 3.24, p=0.005).Conclusions: Low plasma levels (bottom vs. middle quartiles) of L-carnitine the first-trimester pregnancy were associated with a higher risk of GDM and abnormal 1-h PG in Chinese pregnant women.
Keywords: trimethylamine N-oxide, TMAO, TMAO precursors, L-Carnitine, gestational diabetes mellitus, Pregnant Women
Received: 05 Mar 2025; Accepted: 30 May 2025.
Copyright: © 2025 Chen, Pang, Li, Ye, Gou, Wang, Lin, Fan, Deng, Wang and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Geng-dong Chen, Foshan Women and Children Hospital, Foshan, China
Lu-Sha Deng, Foshan Women and Children Hospital, Foshan, China
Li-Juan Wang, Foshan Women and Children Hospital, Foshan, China
Zixing Zhou, Foshan Women and Children Hospital, Foshan, China
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