Maternal serum polyols and its link to gestational diabetes mellitus: A population-based nested case-control study

Sugar alcohols (also called polyols) confer a"healthy"sugar substitute. One of possible reasons to support the safe use in pregnant women is their natural origin and the presence of polyols in maternal and fetal samples during normal human gestation. But little is known about the association between circulating sugar alcohols levels and maternal metabolic disorders during pregnancy.We aimed to detect the concentration of the polyols in participants with and without GDM, and to investigate the association between maternal serum levels of polyols and gestational diabetes mellitus (GDM), as well as newborn outcomes.A nested population-based case-control study was conducted in 109 women with and without GDM. Maternal concentrations of serum erythritol, sorbitol, and xylitol at fasting state were quantified using a time-of-flight mass spectrometry system.In women with GDM, serum concentrations of erythritol and sorbitol were higher, but serum concentrations of xylitol were lower, compared with those in women without GDM. Per 1-SD increment of Box-Cox transformed concentrations of erythritol and sorbitol were associated with the increased odds of GDM by 43% and 155% (95% CI 1.07-1.92 and 95 CI%: 1.77-3.69), while a decreased odd was found for xylitol by 25% (95 CI%: 0.57-1.00). Additionally, per 1-SD increase of Box-Cox transformed concentrations of serum sorbitol was associated with a 52% increased odd of large-for-gestational-age newborns controlling for possible confounders (95% CI 1.00-2.30).Maternal circulating sugar alcohols levels during pregnancy were significantly associated with GDM. These findings provide the potential roles of polyols on maternal metabolic health during pregnancy.