(P07-050-23) Serum Methyl-Donor Nutrient Status in Relation to the Risk of Gestational Diabetes Mellitus

Objectives: Choline and betaine are important nutrients in one-carbon metabolism. Choline can serve as the precursor for betaine which provides the methyl group to homocysteine to form methionine. Trimethylamine N-oxide (TMAO) is a gut microbial-derived metabolite from dietary choline and betaine.

The risk of Gestational Diabetes Mellitus (GDM) has been associated with maternal choline and betaine intake and the formation of TMAO, but results remain inconsistent among women from different ethnicities. The aim of this study is to investigate the relationship between serum choline, betaine, and TMAO levels with the risk of GDM in a cohort of Chinese pregnant women.

Methods: This study is a Case-Control study of 65 hospital-based cases and 220 healthy controls enrolled in 24-28 weeks of gestation at Shanghai Seventh People’s Hospital in China. HPLC-MS/MS was used to measure serum levels of choline, betaine, and TMAO. These women were diagnosed with GDM if they met one or more of the glucose levels: ≥5.1 nmol/L at 0 h, ≥10.0 nmol/L at 1 h, or ≥8.5 nmol/L at 2 h. Unconditional logistic regression model is used to estimate the Odds Ratio (OR) and 95% confidence intervals (CIs) for the correlation between serum choline, betaine, and TMAO with risk of GDM.

Results: Those women who developed GDM tended to be older, have lower betaine intake, and higher Bilirubin, and were more likely to experience second gravidity (each P < 0.05). Serum betaine was inversely correlated with the risk of GDM [OR 0.39, 95% CI (0.15-0.97), P<sub>trend= 0.11] while null association was observed between choline [OR 0.55, 95% CI (0.20-1.48), P<sub>trend= 0.29] or TMAO [OR 1.12, 95% CI (0.37-3.44), P<sub>trend= 0.64] and the risk of GDM after adjustment with multivariable.

Conclusions: Serum betaine, but not serum choline or TMAO, was inversely correlated with risk of GDM among Chinese pregnant women from Shanghai.

Funding Sources: Funding for this research is from Texas State University, San Marcos, Texas, USA.