%0 Journal Article
%T Plasma phospholipid n-3 and n-6 polyunsaturated fatty acids in relation to cardiometabolic markers and gestational diabetes: A longitudinal study within the prospective NICHD Fetal Growth Studies
%A Assiamira Ferrara
%A Cuilin Zhang
%A Huixia Yang
%A Jing Wu
%A Mengying Li
%A Michael Y. Tsai
%A Mohammad L. Rahman
%A Natalie L. Weir
%A Stefanie N. Hinkle
%A Yeyi Zhu
%A Yuan Lin
%J -
%D 2019
%R 10.1371/journal.pmed.1002910
%X Background Despite dietary recommendations of polyunsaturated fatty acids (PUFAs) for cardiometabolic health, n-3 and n-6 PUFAs and their interplay in relation to diabetes risk remain debated. Importantly, data among pregnant women are scarce. We investigated individual plasma phospholipid n-3 and n-6 PUFAs in early to midpregnancy in relation to subsequent risk of gestational diabetes mellitus (GDM).   Methods and findings Within the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies每Singleton Cohort (n = 2,802), individual plasma phospholipid n-3 and n-6 PUFAs levels were measured at gestational weeks (GWs) 10每14, 15每26, 23每31, and 33每39 among 107 GDM cases (ascertained on average at GW 27) and 214 non-GDM controls. Conditional logistic regression was used, adjusting for major risk factors for GDM. After adjusting for covariates, individual n-3 eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) were inversely correlated with insulin-resistance markers, whereas individual n-6 dihomo-gamma-linolenic acid (DGLA) was positively correlated with insulin-resistance markers. At GW 15每26, a standard deviation (SD) increase in total n-3 PUFAs and individual n-3 DPA was associated with a 36% (adjusted odds ratio 0.64; 95% CI 0.42每0.96; P = 0.042) and 33% (0.67; 95% CI 0.45每0.99; P = 0.047) lower risk of GDM, respectively; however, the significance did not persist after post hoc false-discovery rate (FDR) correction (FDR-corrected P values > 0.05). Associations between total n-6 PUFAs and GDM were null, whereas associations with individual n-6 PUFAs were differential. Per SD increase, gamma-linolenic acid (GLA) at GWs 10每14 and DGLA at GWs 10每14 and 15每26 were significantly associated with a 1.40- to 1.95-fold higher risk of GDM, whereas docosatetraenoic acid (DTA) at GW 15每26 was associated with a 45% (0.55; 95% CI 0.37每0.83) lower risk of GDM (all FDR-corrected P values < 0.05). Null associations were observed for linoleic acid (LA) in either gestational window in relation to risk of GDM. Women with high (≡median) n-3 PUFAs and low (<median) n-6 PUFAs levels had a 64% (95% CI 0.14每0.95; P value = 0.039) lower risk of GDM versus women with low n-3 and high n-6 PUFAs. Limitations include the inability to distinguish between exogenous and endogenous influences on circulating PUFA levels and the lack of causality inherent in observational studies.   Conclusions Our findings may suggest a potential role of primarily endogenously metabolized plasma phospholipid n-6 PUFAs including GLA, DGLA, and
%K Phospholipids
%K Fatty acids
%K Gestational diabetes
%K Pregnancy
%K Diabetes mellitus
%K Blood plasma
%K Homeostasis
%K Glucose metabolism
%U https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002910