Canadian journal of diabetes · 2026
Maternal Serum Polyol Levels Associated With Gestational Diabetes Mellitus and Large-for-Gestational-Age Infants: A Population-Based Nested Case-Control Study.
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Tan Tao, Wang Meng, Qi Yicheng, Liu Yu, Qin Li, Ma Jing
Аннотация
OBJECTIVE: Polyols, natural nutritive sweeteners, are often found in the diet during pregnancy. This study investigates the association between maternal serum polyol levels and the risk of gestational diabetes mellitus (GDM) and large-for-gestational-age (LGA) infants.
METHODS: This nested case-control study matched 218 women (with GDM vs. without GDM) by age and body mass index. After exclusions, the final analytic sample comprised 194 women for glucose metabolism outcomes and 177 women for birth weight and LGA outcomes. Serum polyols (sorbitol, erythritol, xylitol, and maltitol) were quantified using gas chromatography coupled with time-of-flight mass spectrometry. LGA was defined as a birth weight ≥90th percentile or ≥4000 g. Logistic regression was used to assess the associations between polyols and GDM and LGA, with adjustment for confounders.
RESULTS: Among the participants, 23.7% had LGA infants, and maternal serum polyol levels were significantly higher in this group. After adjusting for confounders, a 1-standard deviation increase in serum polyol levels was associated with increased odds of LGA (odds ratio=1.71, 95% confidence interval [CI]:1.22 to 2.40) and GDM (OR=1.52, 95% CI: 1.09 to 2.14). Erythritol and sorbitol were significantly associated with the odds of LGA, whereas xylitol and maltitol had no significant associations. Furthermore, a 1-standard deviation increase in serum polyol levels was linked to higher birth weight (beta [β]=95 g, 95% CI: 33 to 157 g) and elevated homeostasis model assessment for insulin resistance (β=0.32, 95% CI: 0.12 to 0.52).
CONCLUSIONS: Elevated maternal serum polyol levels were positively associated with the risk of GDM, LGA infants, and higher birth weight.
METHODS: This nested case-control study matched 218 women (with GDM vs. without GDM) by age and body mass index. After exclusions, the final analytic sample comprised 194 women for glucose metabolism outcomes and 177 women for birth weight and LGA outcomes. Serum polyols (sorbitol, erythritol, xylitol, and maltitol) were quantified using gas chromatography coupled with time-of-flight mass spectrometry. LGA was defined as a birth weight ≥90th percentile or ≥4000 g. Logistic regression was used to assess the associations between polyols and GDM and LGA, with adjustment for confounders.
RESULTS: Among the participants, 23.7% had LGA infants, and maternal serum polyol levels were significantly higher in this group. After adjusting for confounders, a 1-standard deviation increase in serum polyol levels was associated with increased odds of LGA (odds ratio=1.71, 95% confidence interval [CI]:1.22 to 2.40) and GDM (OR=1.52, 95% CI: 1.09 to 2.14). Erythritol and sorbitol were significantly associated with the odds of LGA, whereas xylitol and maltitol had no significant associations. Furthermore, a 1-standard deviation increase in serum polyol levels was linked to higher birth weight (beta [β]=95 g, 95% CI: 33 to 157 g) and elevated homeostasis model assessment for insulin resistance (β=0.32, 95% CI: 0.12 to 0.52).
CONCLUSIONS: Elevated maternal serum polyol levels were positively associated with the risk of GDM, LGA infants, and higher birth weight.