Abstract：
Though gut microbiome disturbance may be involved in the etiology of gestational diabetes mellitus (GDM), data on the gut microbiome\'s dynamic change during pregnancy and associations with gestational glucose metabolism are still inadequate. In this prospective study comprising 120 pairs of GDM patients and matched pregnant controls, a decrease in the diversity of gut microbial species and changes in the microbial community composition with advancing gestation are found in controls, while no such trends are observed in GDM patients. Multivariable analysis identifies 10 GDM-related species (e.g., Alistipes putredinis), and the integrated associations of these species with glycemic traits are modified by habitual intake of fiber-rich plant foods. In addition, the microbial metabolic potentials related to fiber fermentation (e.g., mannan degradation pathways) and their key enzymes consistently emerge as associated with both GDM status and glycemic traits. Microbial features especially those involved in fiber fermentation, provide an incremental predictive value in a prediction model with established risk factors of GDM. These data suggest that the gut microbiome remodeling with advancing gestation is different in GDM patients compared with controls, and dietary fiber fermentation contributes to the influence of gut microbiome on gestational glycemic regulation.
摘要：
虽然肠道微生物组紊乱可能与妊娠期糖尿病（GDM）的病因有关，关于妊娠期肠道微生物组动态变化以及与妊娠期葡萄糖代谢相关的数据仍然不足。在这项前瞻性研究中，包括120对GDM患者和匹配的孕妇对照，在对照组中发现了肠道微生物物种多样性的减少和随着妊娠的进展微生物群落组成的变化，而在GDM患者中没有观察到这种趋势。多变量分析确定了10种与GDM相关的物种(例如，Alistipesputredinis)，习惯性摄入富含纤维的植物性食物会改变这些物种与血糖性状的综合联系。此外,与纤维发酵相关的微生物代谢潜力(例如，甘露聚糖降解途径）及其关键酶始终与GDM状态和血糖性状相关。微生物的特征，尤其是那些涉及纤维发酵，在已建立GDM风险因素的预测模型中提供增量预测值。这些数据表明，与对照组相比，GDM患者随着妊娠进展的肠道微生物组重塑是不同的。和膳食纤维发酵有助于肠道微生物组对妊娠期血糖调节的影响。
