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Review
. 2024 May 21;14(1):31.
doi: 10.1038/s41387-024-00291-5.

Association of gastrointestinal microbiome and obesity with gestational diabetes mellitus-an updated globally based review of the high-quality literatures

Jiahui Li  1 , Min Wang  1 , Shuai Ma  1 , Zhong Jin  1 , Haonan Yin  1 , Shuli Yang  2
Affiliations
Review

Association of gastrointestinal microbiome and obesity with gestational diabetes mellitus-an updated globally based review of the high-quality literatures

Jiahui Li et al. Nutr Diabetes. .

Abstract

Objectives: The purpose of this review is to investigate the relationship between gastrointestinal microbiome, obesity, and gestational diabetes mellitus (GDM) in an objective manner.

Methods: We conducted a thorough and comprehensive search of the English language literatures published in PubMed, Web of Science, and the Cochrane Library from the establishment of the library until 12 December 2023. Our search strategy included both keywords and free words searches, and we strictly applied inclusion and exclusion criteria. Meta-analyses and systematic reviews were prepared.

Results: Six high-quality literature sources were identified for meta-analysis. However, after detailed study and analysis, a certain degree of heterogeneity was found, and the credibility of the combined analysis results was limited. Therefore, descriptive analyses were conducted. The dysbiosis of intestinal microbiome, specifically the ratio of Firmicutes/Bacteroides, is a significant factor in the development of metabolic diseases such as obesity and gestational diabetes. Patients with intestinal dysbiosis and obesity are at a higher risk of developing GDM.

Conclusions: During pregnancy, gastrointestinal microbiome disorders and obesity may contribute to the development of GDM, with all three factors influencing each other. This finding could aid in the diagnosis and management of patients with GDM through further research on their gastrointestinal microbiome.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Bacterial BA biotransformation [21].
Cholesterol is converted to primary BAs in the liver. Primary BAs are conjugated with primarily taurine in mice or glycine in humans before being transported to the gallbladder for storage in the form of bile. On ingestion of dietary fats, primary conjugated BAs (within bile) are released into the gut lumen to aid lipid absorption. Bacteria with BSH deconjugate BAs, thereby weakening their soap-like qualities. This allows other microbiome members to further modify them into secondary BAs. Some secondary BAs can be transported back to the liver, where they are then conjugated. The interaction between the gut microbiome and BAs leads to modulation of FXR and TGR5 agonists and antagonists, and thus, allows the gut microbiome to affect host metabolism (Note: T taurine, G glycine. In humans: TCA taurocholic acid, TCDCA taurochenodeoxycholic acid. In mice: TαMCA tauro-α-uricholic acid, FXR farnesoid X receptor, TGR5 G protein-coupled BA receptor 1).
Fig. 2
Fig. 2
Lipid molecules regulate host metabolism through GPR41 and GPR43 receptor linkage.
Fig. 3
Fig. 3
Association of intestinal microbiota and obesity with GDM.
See this image and copyright information in PMC

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