1.武汉科技大学湖北省妇幼保健院联合培养基地,武汉 430070
2.湖北省妇幼保健院产科,武汉 430070
Received:09 July 2025,
Revised:2025-09-08,
Accepted:27 October 2025,
Published Online:25 November 2025,
移动端阅览
李晓燕,吴召宇,李敏,等.肠道菌群及其代谢产物在妊娠期糖尿病研究进展[J].重庆医科大学学报,
Li Xiaoyan,Wu Zhaoyu,Li Min,et al.Research progress on gut microbiota and their metabolites in gestational diabetes mellitus[J].Journal of Chongqing Medical University,
李晓燕,吴召宇,李敏,等.肠道菌群及其代谢产物在妊娠期糖尿病研究进展[J].重庆医科大学学报, DOI:10.13406/j.cnki.cyxb..
Li Xiaoyan,Wu Zhaoyu,Li Min,et al.Research progress on gut microbiota and their metabolites in gestational diabetes mellitus[J].Journal of Chongqing Medical University, DOI:10.13406/j.cnki.cyxb..
妊娠期糖尿病(gestational diabetes mellitus,GDM)是一种高发的妊娠期代谢性疾病,其发病与肠道菌群失调密切相关。研究表明,GDM孕妇肠道菌群中厚壁菌门/拟杆菌门(F/B)比值异常升高、产短链脂肪酸(short-chain fatty acids,SCFAs)菌群减少,可能导致能量代谢失衡和胰岛素抵抗。益生菌和膳食干预或可改善代谢紊乱,但菌群与GDM的因果关系及地域差异机制仍需深入研究。本文系统检索PubMed、CNKI等数据库,综述肠道菌群如何通过SCFAs代谢、胆汁酸代谢、炎症调节等途径影响糖脂代谢,为GDM的早期筛查和个体化干预提供理论依据。
Gestational diabetes mellitus(GDM) is a common metabolic disorder during pregnancy,and its occurrence is closely associated with gut microbiota dysbiosis. Studies have shown that the abnormally increased ratio of Firmicutes/Bacteroidetes in the gut microbiota and the reduced short-chain fatty acid(SCFA)-producing flora may lead to energy metabolism imbalance and insulin resistance in pregnant women with GDM. Probiotics and dietary interventions may improve metabolic disorders,but the causal relationship between the flora and GDM as well as the mechanism of regional differences still need to be further studied. Based on a systematic retrieval of databases such as PubMed and CNKI,this article reviews how the gut microbiota affect glucose and lipid metabolism through pathways such as SCFA metabolism,bile acid metabolism,and inflammatory regulation. Thus,it provides a theoretical basis for the early screening and individualized intervention of GDM.
钟 静 , 吴和明 , 张 华 , 等 . 肠道菌群及其代谢产物与妊娠期糖尿病的关系研究进展 [J ] . 转化医学杂志 , 2024 , 13 ( 3 ): 495 - 498 .
Zhong J , Wu HM , Zhang H , et al . Research on the relationship between intestinal flora and its metabolites and gestational diabetes mellitus [J ] . Transl Med J , 2024 , 13 ( 3 ): 495 - 498 .
Wu YW , Wang Z , Zhao Z , et al . Bile acid metabolites in early pregnancy and risk of gestational diabetes mellitus: Results from a prospective cohort study [J ] . Diabetes Obes Metab , 2023 , 25 ( 8 ): 2255 - 2267 .
郝泽锦 , 徐积兄 . 肠道菌群与妊娠期糖尿病关系的研究进展 [J ] . 中国糖尿病杂志 , 2024 , 32 ( 6 ): 468 - 470 .
Hao ZJ , Xu JX . Research progress on the relationship between intestinal flora and gestational diabetes mellitus [J ] . Chin J Diabetes , 2024 , 32 ( 6 ): 468 - 470 .
Asbury MR , Butcher J , Copeland JK , et al . Mothers of preterm infants have individualized breast milk microbiota that changes temporally based on maternal characteristics [J ] . Cell Host Microbe , 2020 , 28 ( 5 ): 669 - 682 . e4.
Fan Y , Pedersen O . Gut microbiota in human metabolic health and disease [J ] . Nat Rev Microbiol , 2021 , 19 ( 1 ): 55 - 71 .
Ponzo V , Fedele D , Goitre I , et al . Diet-gut microbiota interactions and gestational diabetes mellitus(GDM) [J ] . Nutrients , 2019 , 11 ( 2 ): 330 .
Martin-Gallausiaux C , Marinelli L , Blottière HM , et al . SCFA: mechanisms and functional importance in the gut [J ] . Proc Nutr Soc , 2021 , 80 ( 1 ): 37 - 49 .
Canfora EE , Meex RCR , Venema K , et al . Gut microbial metabolites in obesity,NAFLD and T2DM [J ] . Nat Rev Endocrinol , 2019 , 15 ( 5 ): 261 - 273 .
Sun H , Saeedi P , Karuranga S , et al . IDF Diabetes Atlas: Global,regional and country-level diabetes prevalence estimates for 2021 and projections for 2045 [J ] . Diabetes Res Clin Pract , 2022 , 183 : 109119 .
Huang YN , Liu JX , Tun HM , et al . Gut microbiota insights into human adaption to high-plateau diet [J ] . Imeta , 2022 , 1 ( 1 ): e6 .
Crusell MKW , Hansen TH , Nielsen T , et al . Gestational diabetes is associated with change in the gut microbiota composition in third trimester of pregnancy and postpartum [J ] . Microbiome , 2018 , 6 ( 1 ): 89 .
Kampmann U , Knorr S , Fuglsang J , et al . Determinants of maternal insulin resistance during pregnancy: an updated overview [J ] . J Diabetes Res , 2019 , 2019 : 5320156 .
Garcia-Gutierrez E , O’Mahony AK , Dos Santos RS , et al . Gut microbial metabolic signatures in diabetes mellitus and potential preventive and therapeutic applications [J ] . Gut Microbes , 2024 , 16 ( 1 ): 2401654 .
Wang YT , Shu X , Zhou Q , et al . Selenite reduction and the biogenesis of selenium nanoparticles by alcaligenesfaecalis Se03 isolated from the gut of Monochamus alternatus (Coleoptera: Cerambycidae) [J ] . Int J Mol Sci , 2018 , 19 ( 9 ): 2799 .
Hasain Z , Mokhtar NM , Kamaruddin NA , et al . Gut microbiota and gestational diabetes mellitus: a review of host-gut microbiota interactions and their therapeutic potential [J ] . Front Cell Infect Microbiol , 2020 , 10 : 188 .
Lu XW , Shi Z , Jiang LL , et al . Maternal gut microbiota in the health of mothers and offspring: from the perspective of immunology [J ] . Front Immunol , 2024 , 15 : 1362784 .
Cortez AJ , Tudrej P , Kujawa KA , et al . Advances in ovarian cancer therapy [J ] . Cancer Chemother Pharmacol , 2018 , 81 ( 1 ): 17 - 38 .
Ye GY , Zhang L , Wang M , et al . The gut microbiota in women suffering from gestational diabetes mellitus with the failure of glycemic control by lifestyle modification [J ] . J Diabetes Res , 2019 , 2019 : 6081248 .
Wang JF , Zheng JY , Shi WY , et al . Dysbiosis of maternal and neonatal microbiota associated with gestational diabetes mellitus [J ] . Gut , 2018 , 67 ( 9 ): 1614 - 1625 .
Huang LL , Thonusin C , Chattipakorn N , et al . Impacts of gut microbiota on gestational diabetes mellitus: a comprehensive review [J ] . Eur J Nutr , 2021 , 60 ( 5 ): 2343 - 2360 .
Pervjakova N , Moen GH , Borges MC , et al . Multi-ancestry genome-wide association study of gestational diabetes mellitus highlights genetic links with type 2 diabetes [J ] . Hum Mol Genet , 2022 , 31 ( 19 ): 3377 - 3391 .
Wang XL , Huang J , Zheng YX , et al . Study on the relationship between DNA methylation of target CpG sites in peripheral blood and gestational diabetes during early pregnancy [J ] . Sci Rep , 2021 , 11 ( 1 ): 20455 .
Ecklu-Mensah G , Choo-Kang C , Maseng MG , et al . Gut microbiota and fecal short chain fatty acids differ with adiposity and country of origin: the METS-microbiome study [J ] . Nat Commun , 2023 , 14 ( 1 ): 5160 .
王 山 , 倪 艳 , 傅君芬 . 肠道屏障在肥胖相关代谢性疾病发生发展中的作用 [J ] . 重庆医科大学学报 , 2023 , 48 ( 2 ): 226 - 234 .
Wang S , Ni Y , Fu JF . Role of intestinal barrier in the occurrence and development of obesity related metabolic diseases [J ] . J Chongqing Med Univ , 2023 , 48 ( 2 ): 226 - 234 .
Li HL , Liu SQ , Chen H , et al . Gut dysbiosis contributes to SCFAs reduction-associated adipose tissue macrophage polarization in gestational diabetes mellitus [J ] . Life Sci , 2024 , 350 : 122744 .
Modzelewski R , Stefanowicz-Rutkowska MM , Matuszewski W , et al . Gestational diabetes mellitus-recent literature review [J ] . J Clin Med , 2022 , 11 ( 19 ): 5736 .
Liu Y , Qin ST , Feng Y , et al . Perturbations of gut microbiota in gestational diabetes mellitus patients induce hyperglycemia in germ-free mice [J ] . J Dev Orig Health Dis , 2020 , 11 ( 6 ): 580 - 588 .
Choudhury AA , Devi Rajeswari V . Gestational diabetes mellitus-A metabolic and reproductive disorder [J ] . Biomed Pharmacother , 2021 , 143 : 112183 .
Chen H , Wang SH , Li HL , et al . The attenuation of gut microbiota-derived short-chain fatty acids elevates lipid transportation through suppression of the intestinal HDAC3-H3K27ac-PPAR-γ axis in gestational diabetes mellitus [J ] . J Nutr Biochem , 2024 , 133 : 109708 .
Wikström Shemer E , Marschall HU , Ludvigsson JF , et al . Intrahepatic cholestasis of pregnancy and associated adverse pregnancy and fetal outcomes: a 12-year population-based cohort study [J ] . BJOG , 2013 , 120 ( 6 ): 717 - 723 .
Kong M , Lu Z , Zhong C , et al . A higher level of total bile acid in early mid-pregnancy is associated with an increased risk of gestational diabetes mellitus: a prospective cohort study in Wuhan,China [J ] . J Endocrinol Invest , 2020 , 43 ( 8 ): 1097 - 1103 .
Nayak SS , Kuriyakose D , Polisetty LD , et al . Diagnostic and prognostic value of triglyceride glucose index: a comprehensive evaluation of meta-analysis [J ] . Cardiovasc Diabetol , 2024 , 23 ( 1 ): 310 .
Hou WL , Meng XY , Zhao WJ , et al . Elevated first-trimester total bile acid is associated with the risk of subsequent gestational diabetes [J ] . Sci Rep , 2016 , 6 : 34070 .
Garcia-Flores J , Cañamares M , Cruceyra M , et al . Clinical value of maternal bile Acid quantification in intrahepatic cholestasis of pregnancy as an adverse perinatal outcome predictor [J ] . Gynecol Obstet Invest , 2015 , 79 ( 4 ): 222 - 228 .
Gurung M , Li ZP , You H , et al . Role of gut microbiota in type 2 diabetes pathophysiology [J ] . EBioMedicine , 2020 , 51 : 102590 .
Gomez Ribot D , Diaz E , Fazio MV , et al . An extra virgin olive oil-enriched diet improves maternal,placental,and cord blood parameters in GDM pregnancies [J ] . Diabetes Metab Res Rev , 2020 , 36 ( 8 ): e3349 .
Zhu B , Yin PY , Ma ZX , et al . Characteristics of bile acids metabolism profile in the second and third trimesters of normal pregnancy [J ] . Metabolism , 2019 , 95 : 77 - 83 .
Li J , Huo XX , Cao YF , et al . Bile acid metabolites in early pregnancy and risk of gestational diabetes in Chinese women: A nested case-control study [J ] . EBioMedicine , 2018 , 35 : 317 - 324 .
Fan HM , Mitchell AL , Williamson C . ENDOCRINOLOGY IN PREGNANCY: Metabolic impact of bile acids in gestation [J ] . Eur J Endocrinol , 2021 , 184 ( 3 ): R69 - R83 .
Lu CX , Li CY , Lei XP . Bile acids and gestational diabetes mellitus: exploring the link and implications - a review [J ] . Front Endocrinol , 2025 , 16 : 1574228 .
Neinast M , Murashige D , Arany Z . Branched chain amino acids [J ] . Annu Rev Physiol , 2019 , 81 : 139 - 164 .
Mangogna A , Di Girolamo FG , Fiotti N , et al . High-protein diet with excess leucine prevents inactivity-induced insulin resistance in women [J ] . Clin Nutr , 2023 , 42 ( 12 ): 2578 - 2587 .
De Bandt JP , Coumoul X , Barouki R . Branched-chain amino acids and insulin resistance,from protein supply to diet-induced obesity [J ] . Nutrients , 2022 , 15 ( 1 ): 68 .
Ramzan I , Ardavani A , Vanweert F , et al . The association between circulating branched chain amino acids and the temporal risk of developing type 2 diabetes mellitus: a systematic review & meta-analysis [J ] . Nutrients , 2022 , 14 ( 20 ): 4411 .
Allman BR , Diaz EC , Andres A , et al . Divergent changes in serum branched-chain amino acid concentrations and estimates of insulin resistance throughout gestation in healthy women [J ] . J Nutr , 2020 , 150 ( 7 ): 1757 - 1764 .
Hou WL , Meng XY , Zhao AH , et al . Development of multimarker diagnostic models from metabolomics analysis for gestational diabetes mellitus (GDM) [J ] . Mol Cell Proteomics , 2018 , 17 ( 3 ): 431 - 441 .
苑莉莉 , 何 峥 . 氧化三甲胺在糖尿病中的研究进展 [J ] . 实用老年医学 , 2022 , 36 ( 1 ): 2 - 5 .
Yuan LL , He Z . Research progress of trimethylamine oxide in diabetes mellitus [J ] . Pract Geriatr , 2022 , 36 ( 1 ): 2 - 5 .
韩慧明 , 陈绵平 , 程 虹 , 等 . 妊娠期糖尿病患者血清miR-26b、TMAO表达变化及与产后糖代谢异常的相关性 [J ] . 中国性科学 , 2024 , 33 ( 6 ): 106 - 110 .
Han HM , Chen MP , Cheng H , et al . Changes of serum microRNA-26b and trimethylamine oxide expression in patients with gestational diabetes mellitus and their correlation with postpartum glucose metabolic abnormalities [J ] . Chin J Hum Sex , 2024 , 33 ( 6 ): 106 - 110 .
罗芳丽 , 孙路强 , 王司琦 , 等 . 肠道屏障功能评估技术的研究进展 [J ] . 重庆医科大学学报 , 2025 , 50 ( 1 ): 23 - 29 .
Luo FL , Sun LQ , Wang SQ , et al . Research progress on assessment techniques for intestinal barrier function [J ] . J Chongqing Med Univ , 2025 , 50 ( 1 ): 23 - 29 .
Bagarolli RA , Tobar N , Oliveira AG , et al . Probiotics modulate gut microbiota and improve insulin sensitivity in DIO mice [J ] . J Nutr Biochem , 2017 , 50 : 16 - 25 .
Collado MC , Meriluoto J , Salminen S . Role of commercial probiotic strains against human pathogen adhesion to intestinal mucus [J ] . Lett Appl Microbiol , 2007 , 45 ( 4 ): 454 - 460 .
陈海燕 , 戴 霞 , 张迷磊 , 等 . 基于肠道菌群探讨运动改善2型糖尿病小鼠骨髓内皮组细胞功能的影响研究 [J ] . 重庆医科大学学报 , 2024 , 49 ( 3 ): 254 - 263 .
Chen HY , Dai X , Zhang ML , et al . To investigate the effect of exercise on the function of bone marrow endothelial cells in type 2 diabetic mice based on intestinal flora [J ] . J Chongqing Med Univ , 2024 , 49 ( 3 ): 254 - 263 .
江志发 , 叶湘云 , 曹丹丹 , 等 . 代谢组学在妊娠期糖尿病中的研究进展 [J ] . 中国计划生育和妇产科 , 2023 , 15 ( 6 ): 21 - 25 .
Jiang ZF , Ye XY , Cao DD , et al . Research progress of metabolomics in gestational diabetes mellitus [J ] . Chin J Fam Plan Gynecotokology , 2023 , 15 ( 6 ): 21 - 25 .
Yu J , Ren J , Ren YL , et al . Using metabolomics and proteomics to identify the potential urine biomarkers for prediction and diagnosis of gestational diabetes [J ] . EBioMedicine , 2024 , 101 : 105008 .
Adachi Y , De Sousa-Coelho AL , Harata I , et al . L-Alanine activates hepatic AMP-activated protein kinase and modulates systemic glucose metabolism [J ] . Mol Metab , 2018 , 17 : 61 - 70 .
Alesi S , Ghelani D , Rassie K , et al . Metabolomic biomarkers in gestational diabetes mellitus: a review of the evidence [J ] . Int J Mol Sci , 2021 , 22 ( 11 ): 5512 .
Ye DW , Huang JT , Wu JM , et al . Integrative metagenomic and metabolomic analyses reveal gut microbiota-derived multiple hits connected to development of gestational diabetes mellitus in humans [J ] . Gut Microbes , 2023 , 15 ( 1 ): 2154552 .
Chen T , Qin YF , Chen MJ , et al . Gestational diabetes mellitus is associated with the neonatal gut microbiota and metabolome [J ] . BMC Med , 2021 , 19 ( 1 ): 120 .
Xie JW , Li L , Xing HY . Metabolomics in gestational diabetes mellitus: A review [J ] . Clin Chim Acta , 2023 , 539 : 134 - 143 .
Zhang MQ , Yang HX . Perspectives from metabolomics in the early diagnosis and prognosis of gestational diabetes mellitus [J ] . Front Endocrinol , 2022 , 13 : 967191 .
Christensen L , Roager HM , Astrup A , et al . Microbial enterotypes in personalized nutrition and obesity management [J ] . Am J Clin Nutr , 2018 , 108 ( 4 ): 645 - 651 .
Tanaka K , Harata G , Miyazawa K , et al . The gut microbiota of non-obese Japanese pregnant women with gestational diabetes mellitus [J ] . Biosci Microbiota Food Health , 2022 , 41 ( 1 ): 4 - 11 .
苏 尧 , 陈 莉 , 徐先明 . 超重孕妇的肠道菌群与妊娠期糖尿病的关系 [J ] . 现代妇产科进展 , 2021 , 30 ( 12 ): 881 - 886 .
Su Y , Chen L , Xu XM . The relationship between Gut microbiota of overweight pregnant women and gestational diabetes mellitus [J ] . Prog Obstet Gynecol , 2021 , 30 ( 12 ): 881 - 886 .
Mokkala K , Paulin N , Houttu N , et al . Metagenomics analysis of gut microbiota in response to diet intervention and gestational diabetes in overweight and obese women: a randomised,double-blind,placebo-controlled clinical trial [J ] . Gut , 2021 , 70 ( 2 ): 309 - 318 .
Chen T , Zhang YQ , Zhang YY , et al . Relationships between gut microbiota,plasma glucose and gestational diabetes mellitus [J ] . J Diabetes Investig , 2021 , 12 ( 4 ): 641 - 650 .
滑丽美 , 胡丽叶 , 李丽君 , 等 . 不同剂量益生菌对妊娠糖尿病患者糖脂代谢指标的影响 [J ] . 临床误诊误治 , 2025 , 38 ( 10 ): 73 - 80 .
Hua LM , Hu LY , Li LJ , et al . Effect of different doses of probiotics on glucose and lipid metabolism indicators in gestational diabetes mellitus [J ] . Clin Misdiagnosis Mistherapy , 2025 , 38 ( 10 ): 73 - 80 .
Yang X , Zhang MZ , Zhang YQ , et al . Ecological change of the gut microbiota during pregnancy and progression to dyslipidemia [J ] . NPJ Biofilms Microbiomes , 2023 , 9 ( 1 ): 14 .
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
