Metabolomic biomarkers of the mediterranean diet in pregnant individuals: A prospective study

Liwei Chen; Jin Dai; Zhe Fei; Xinyue Liu; Yeyi Zhu; Mohammad L Rahman; Ruijin Lu; Susanna D Mitro; Jiaxi Yang; Stefanie N Hinkle; Zhen Chen; Yiqing Song; Cuilin Zhang

doi:10.1016/j.clnu.2023.01.011

Metabolomic biomarkers of the mediterranean diet in pregnant individuals: A prospective study

Clin Nutr. 2023 Mar;42(3):384-393. doi: 10.1016/j.clnu.2023.01.011. Epub 2023 Jan 14.

Authors

Liwei Chen¹, Jin Dai², Zhe Fei³, Xinyue Liu⁴, Yeyi Zhu⁵, Mohammad L Rahman⁶, Ruijin Lu⁷, Susanna D Mitro⁸, Jiaxi Yang⁹, Stefanie N Hinkle¹⁰, Zhen Chen¹¹, Yiqing Song¹², Cuilin Zhang¹³

Affiliations

¹ Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA. Electronic address: cliwei86@ucla.edu.
² Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA. Electronic address: daijin@ucla.edu.
³ Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA. Electronic address: feiz@g.ucla.edu.
⁴ Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA. Electronic address: xinyue2396@g.ucla.edu.
⁵ Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94612, USA. Electronic address: yeyi.zhu@kp.org.
⁶ Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA. Electronic address: mohammad.rahman2@nih.gov.
⁷ Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA. Electronic address: ruijin.lu@nih.gov.
⁸ Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA. Electronic address: susanna.mitro@nih.gov.
⁹ Global Center for Asian Women's Health, and Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, 117549, Singapore; Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore. Electronic address: jiaxiyang@g.harvard.edu.
¹⁰ Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. Electronic address: Stefanie.hinkle@pennmedicine.upenn.edu.
¹¹ Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA. Electronic address: chenzhe@mail.nih.gov.
¹² Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA. Electronic address: syq1@yahoo.com.
¹³ Global Center for Asian Women's Health, and Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, 117549, Singapore; Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore. Electronic address: obgzc@nus.edu.sg.

Abstract

Background and aims: Metabolomic profiling is a systematic approach to identifying biomarkers for dietary patterns. Yet, metabolomic markers for dietary patterns in pregnant individuals have not been investigated. The aim of this study was to identify plasma metabolomic markers and metabolite panels that are associated with the Mediterranean diet in pregnant individuals.

Methods: This is a prospective study of 186 pregnant individuals who had both dietary intake and metabolomic profiles measured from the Fetal Growth Studies-Singletons cohort. Dietary intakes during the peri-conception/1st trimester and the second trimester were accessed at 8-13 and 16-22 weeks of gestation, respectively. Adherence to the Mediterranean diet was measured by the alternate Mediterranean Diet (aMED) score. Fasting plasma samples were collected at 16-22 weeks and untargeted metabolomics profiling was performed using the mass spectrometry-based platforms. Metabolites individually or jointly associated with aMED scores were identified using linear regression and least absolute shrinkage and selection operator (LASSO) regression models with adjustment for potential confounders, respectively.

Results: Among 459 annotated metabolites, 64 and 41 were individually associated with the aMED scores of the diet during the peri-conception/1st trimester and during the second trimester, respectively. Fourteen metabolites were associated with the Mediterranean diet in both time windows. Most Mediterranean diet-related metabolites were lipids (e.g., acylcarnitine, cholesteryl esters (CEs), linoleic acid, long-chain triglycerides (TGs), and phosphatidylcholines (PCs), amino acids, and sugar alcohols. LASSO regressions also identified a 10 metabolite-panel that were jointly associated with aMED score of the diet during the peri-conception/1st trimester (AUC: 0.74; 95% CI: 0.57, 0.91) and a 3 metabolites-panel in the 2nd trimester (AUC: 0.68; 95% CI: 0.50, 0.86).

Conclusion: We identified plasma metabolomic markers for the Mediterranean diet among pregnant individuals. Some of them have also been reported in previous studies among non-pregnant populations, whereas others are novel. The results from our study warrant replication in pregnant individuals by future studies.

Clinical trial registration number: This study was registered at ClinicalTrials.gov.

Keywords: Dietary patterns; Mediterranean diet; Metabolomics; Plasma biomarkers; Pregnant individuals.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural

MeSH terms

Biomarkers
Diet, Mediterranean*
Fasting
Humans
Metabolomics / methods
Prospective Studies

Substances

Biomarkers

Abstract

Publication types

MeSH terms

Substances

Grants and funding