Effects Of Xylooligosaccharides On Improving Gestational Diabetes Mellitus By Modulating Gut Microbiota

Gestational diabetes mellitus(GDM)is a type of diabetes that occurs or is diagnosed in women during pregnancy and its incidence has increased rapidly in recent years.Not only affect the life and health of the fetus and pregnant women,but also significantly increase the probability of future generations of obesity and type 2 diabetes.At present,the GDM prevention and control guidelines prohibit the use of other diabetes drugs other than insulin to prevent and treat GDM.Therefore,it is particularly urgent to find a safe and effective method for GDM.A large number of studies have shown that the addition of probiotics and prebiotics to the diet can improve diabetes by modulating gut microbiota.Xylooligosaccharide(XOS),as a prebiotic,is difficult to be decomposed by human digestive enzymes and has a excellent effect of promoting the proliferation of Bifidobacterium.In order to study the prevention and improvement effect of XOS modulating gut microbiota on GDM,this study recruited pregnant women with high risk factors for GDM in first trimester(11-14 gestational weeks)by according to the principle of randomized parallel controlled trial.According to the diagnosis,inclusion and exclusion criteria,qualified pregnant women who signed the informed consent were selected as the research object and were randomly divided into two groups.The control group(group C)received dietary guidance during pregnancy and took placebo at a dose of 6 g/d.The intervention group(group X)received dietary guidance during pregnancy and take XOS at a dose of 6 g/d.Both groups were tested for 12 weeks.In the end,36 people in group C and 34 people in group X were included in the final analysis.First of all,in terms of general clinical data,XOS,a food raw material,caused insignificant changes.After the 12-week trial,there were no significant differences in heart rate,blood pressure and the number of women diagnosed with GDM in the second trimester(p>0.05).At the time of final delivery,there were no significant differences in the gestational weeks,cesarean section rate,neonatal apgar score,and weight of pregnant women in groups C and X(p>0.05).And then,in terms of clinical phenotype,XOS has a good effect on improving the glucose metabolism of pregnant women,especially can significantly reduce the fasting blood glucose of pregnant women(p<0.01).XOS also can control the increase of fasting insulin concentration,effectively improve the insulin resistance of pregnant women during the second trimester(p<0.01)and further increase insulin sensitivity.Although the total cholesterol and triglyceride indexes of the two groups of pregnant women were not significantly different(p>0.05),they had a tendency to inhibit the weight gain of pregnant women(p=0.0652).In addition,it was found that XOS did not reduce the secretion of estradiol and progesterone in pregnant women to ensure the normal growth of estradiol and progesterone and provide support for the early growth and development of the fetus.Moreover,XOS had the tendency to inhibit cortisol increse(p=0.0556)and improve leptin resistance(p=0.0582).XOS significantly inhibited the decrease of the secretion of inflammation inhibitory factor IL-10 in pregnant women(p<0.01)and had a powerful ability to alleviate pregnant women's oxidative stress.XOS can significantly inhibit the reduction of antioxidants such as catalase(p<0.01),superoxide dismutase(p<0.001)in pregnant women and the production of strong oxidants such as nitric oxide(p<0.001)in pregnant women.In the end,in terms of gut microbiota,XOS can enrich Bifidobacterium intensively and can increase its abundance in group X by 137.26% and only 6.58% in group C.The modulation of XOS on gut microbiota of pregnant women mainly changed its function(p<0.05).XOS improved GDM mainly by enriching glutathione metabolism and other pathways,enriching EC 6.4.1.3-producing genes to reduce propionate production,and promoting the production of acetate and other short-chain fatty acids(SCFAs).Compared with other gut bacteria,the abundance of Megasphaera in group C decreased by 28.26%,while the abundance in group X increased by 135.11% and there was a significant difference in abundance change between the two groups(p<0.05).Both LEfSe analysis and random forest model selected Megasphaera as key genus.In addition,Megasphaera had a higher contribution to the genes that promote the production of SCFAs,and was significantly correlated with fasting blood glucose,IL-6,leptin,nitric oxide,and superoxide dismutase(p<0.05).Ultimately,Megasphaera was the core bacterium for XOS to improve GDM.Overall,XOS had a gratifying effect on the improvement and prevention of GDM.XOS mainly worked by enriching bacteria such as Bifidobacterium and Megasphaera,and its mechanism of effect on GDM needs to be confirmed by further research.