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Aims/hypothesis <p>Women with a history of gestational diabetes mellitus (GDM) have an elevated risk of type 2 diabetes in their later life, yet the underlying mechanisms of this remain unclear. We aimed to investigate the long-term impact of GDM on gut microbiota and related metabolites and to explore whether such alterations may contribute to type 2 diabetes risk.</p> Methods <p>Among parous women from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we identified microbial species associated with a history of GDM (visit 2, 2014–2017, <i>n</i>=1525), and serum metabolites associated with both a history of GDM (visit 1, 2008–2011, <i>n</i>=2968) and GDM-related microbiota (visit 2, <i>n</i>=391). We further examined prospective associations of the GDM-related microbiome (visit 2, <i>n</i>=925) with incident type 2 diabetes over 6 years of follow-up, and of microbial-related metabolites (visit 1, <i>n</i>=2341) with incident type 2 diabetes over 12 years.</p> Results <p>Among 1525 US Hispanic/Latino parous women (median age: 58 years), seven species differed between women with and without a history of GDM, including higher abundances of four species (e.g. <i>Parabacteroides merdae CAG:48</i>, a proinflammatory taxon) and lower abundances of three species (e.g. <i>Dialister sp. CAG:588</i>, a short-chain fatty acid producer). Fifteen metabolites were associated with both a history of GDM and the GDM-related microbiome in a consistent direction, nine of which (e.g. saturated sphingomyelins and unsaturated fatty acids) were associated with glycaemic traits and incident type 2 diabetes. Using these microbial-related metabolites as proxy measures, proxy analysis suggested a positive relationship between the GDM-related microbiome and type 2 diabetes (<i>r</i>=0.55, <i>p</i>=0.036). A metabolite score derived from the nine microbial-related metabolites mediated an estimated 20% (95% CI 9%, 42%) of the association between a history of GDM and type 2 diabetes.</p> Conclusions/interpretation <p>A history of GDM is associated with an unfavourable gut microbiota and related metabolites in US Hispanic/Latino women, suggesting a potential role of the gut microbiota in GDM-related type 2 diabetes.</p> Graphical Abstract <p></p>

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Gestational diabetes and risk of type 2 diabetes: exploring the role of the gut microbiome in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月30日

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  • Yi Wang,
  • Carmen R. Isasi,
  • Alison M. Stuebe,
  • Adetola F. Louis-Jacques,
  • Jie Hu,
  • Gang Hu,
  • Martha L. Daviglus,
  • Eric Boerwinkle,
  • Robert D. Burk,
  • Robert C. Kaplan,
  • Qibin Qi,
  • Brandilyn A. Peters

摘要

Aims/hypothesis

Women with a history of gestational diabetes mellitus (GDM) have an elevated risk of type 2 diabetes in their later life, yet the underlying mechanisms of this remain unclear. We aimed to investigate the long-term impact of GDM on gut microbiota and related metabolites and to explore whether such alterations may contribute to type 2 diabetes risk.

Methods

Among parous women from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we identified microbial species associated with a history of GDM (visit 2, 2014–2017, n=1525), and serum metabolites associated with both a history of GDM (visit 1, 2008–2011, n=2968) and GDM-related microbiota (visit 2, n=391). We further examined prospective associations of the GDM-related microbiome (visit 2, n=925) with incident type 2 diabetes over 6 years of follow-up, and of microbial-related metabolites (visit 1, n=2341) with incident type 2 diabetes over 12 years.

Results

Among 1525 US Hispanic/Latino parous women (median age: 58 years), seven species differed between women with and without a history of GDM, including higher abundances of four species (e.g. Parabacteroides merdae CAG:48, a proinflammatory taxon) and lower abundances of three species (e.g. Dialister sp. CAG:588, a short-chain fatty acid producer). Fifteen metabolites were associated with both a history of GDM and the GDM-related microbiome in a consistent direction, nine of which (e.g. saturated sphingomyelins and unsaturated fatty acids) were associated with glycaemic traits and incident type 2 diabetes. Using these microbial-related metabolites as proxy measures, proxy analysis suggested a positive relationship between the GDM-related microbiome and type 2 diabetes (r=0.55, p=0.036). A metabolite score derived from the nine microbial-related metabolites mediated an estimated 20% (95% CI 9%, 42%) of the association between a history of GDM and type 2 diabetes.

Conclusions/interpretation

A history of GDM is associated with an unfavourable gut microbiota and related metabolites in US Hispanic/Latino women, suggesting a potential role of the gut microbiota in GDM-related type 2 diabetes.

Graphical Abstract