Abstract: Objective  To explore the relationship between circulating fatty acids in early pregnancy and incident gestational diabetes mellitus (GDM) among Chinese pregnant women. Methods  We established a prospective nested case-control study using data from an ongoing cohort, which enrolled women in early pregnancy and followed them up in China. Fourty-three GDM cases were identified and matched on maternal age and pregestational body mass index to 43 pregnant women who did not develop GDM during their pregnancy. Maternal clinical data were collected, including fasting plasma glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high density lipoprotein cholesterol in the first trimester of pregnancy, three point blood glucose of oral glucose tolerance test during the second trimester of pregnancy. Plasma fatty acids were determined by gas chromatography-mass spectrometry. Results  (1) Levels of myristic acid, palmitic acid, palmitoleic acid, stearic acid during the first trimester of pregnancy in GDM group were significantly higher than in control group［（4.35±2.50）μmol/L vs（3.08±1.79）μmol/L,（23.28±8.70）μmol/L vs（18.12±6.94)μmol/L,（7.33±4.69）μmol/L vs（5.22±4.45）μmol/L,（12.50±4.39）μmol/L vs（9.41±3.45）μmol/L, respectively ］. While there were two fatty acids that were significantly lower in GDM group than in control group, which is linolelaidic acid, linolenic acid. Logistic regression indicated that higher levels of palmitic acid（OR=1.32;95% CI:1.14-1.54), palmitoleic acid（OR=1.52;95% CI:1.17-1.99) were associated with higher odds of GDM. However, the level of linolelaidic acid were negatively associated with the incidence of GDM. Conclusion  We documented adverse associations of palmitic acid and palmitoleic acid but a protective association of linolelaidic acid with GDM among Chinese pregnant women.

Key words: gestational diabetes mellitus, serum free fatty acids, early prediction