Docosahexaenoic acid supplementation in gestational diabetes mellitus and neonatal metabolic health biomarkers

Ya-Jie Xu; Wen-Juan Wang; Qiu-Yi Zhang; Meng-Nan Yang; Lin Zhang; Hua He; Yu Dong; Fengxiu Ouyang; Ying Gao; Jun Zhang; Tao Zheng; Zhong-Cheng Luo

doi:10.3389/fnut.2023.1089131

Docosahexaenoic acid supplementation in gestational diabetes mellitus and neonatal metabolic health biomarkers

Front Nutr. 2023 Mar 20:10:1089131. doi: 10.3389/fnut.2023.1089131. eCollection 2023.

Authors

Ya-Jie Xu^{1

2}, Wen-Juan Wang^{1

3}, Qiu-Yi Zhang⁴, Meng-Nan Yang¹, Lin Zhang⁵, Hua He¹, Yu Dong¹, Fengxiu Ouyang¹, Ying Gao⁴, Jun Zhang¹, Tao Zheng⁶, Zhong-Cheng Luo^{1

2}

Affiliations

¹ Department of Pediatrics, Xinhua Hospital, Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
² Department of Obstetrics and Gynecology, Faculty of Medicine, Prosserman Centre for Population Health Research, Mount Sinai Hospital, Lunenfeld-Tanenbaum Research Institute, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
³ Clinical Skills Center, School of Clinical and Basic Medical Sciences, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China.
⁴ CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China.
⁵ Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
⁶ Department Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.

Abstract

Background and objective: Gestational diabetes mellitus (GDM) "programs" an elevated risk of metabolic dysfunctional disorders in the offspring, and has been associated with elevated leptin and decreased adiponectin levels in cord blood. We sought to assess whether docosahexaenoic acid (DHA) supplementation in GDM affects neonatal metabolic health biomarkers especially leptin and adiponectin.

Methods: In a randomized controlled trial, singleton pregnant women with de novo diagnosis of GDM at 24-28 weeks of gestation were randomized to dietary supplementation of 500 mg DHA per day (intervention, n = 30) until delivery or standard care (control, n = 38). The primary outcomes were cord blood leptin and total adiponectin concentrations. Secondary outcomes included high-molecular-weight (HMW) adiponectin and insulin-like growth factor-1 (IGF-1) concentrations in cord blood, maternal glycemic control post-intervention and birth weight (z score). In parallel, 38 euglycemic pregnant women were recruited for comparisons of cord blood biomarkers.

Results: There were no significant differences in cord serum leptin, total and HMW adiponectin and IGF-1 concentrations between DHA supplementation and control groups (all p > 0.05). Maternal fasting and 2-h postprandial blood glucose levels at 12-16 weeks post-intervention were similar between the two groups. The newborns in the DHA group had higher birth weight z scores (p = 0.02). Cord blood total and HMW adiponectin concentrations were significantly lower in GDM vs. euglycemic pregnancies.

Conclusion: Docosahexaenoic acid supplementation at 500 mg/day in GDM women did not affect neonatal metabolic biomarkers including leptin, adiponectin and IGF-1. The results are reassuring in light of the absence of influence on neonatal adipokines (leptin and adiponectin), and potential benefits to fetal growth and development.

Clinical trial registration: Clinicaltrials.gov, NCT03569501.

Keywords: DHA (22:6ω–3); adiponectin; cord blood; gestational diabetes mellitus; leptin; prenatal intervention.

Associated data

ClinicalTrials.gov/NCT03569501