Previous studies on circulating monounsaturated fatty acids (MUFAs) and the risk of gestational diabetes (GDM) are limited although MUFAs have been implicated outside of pregnancy in glucose homeostasis. The aim of this study was to prospectively investigate levels of total and individual MUFAs (16:1n-7c, 18:1n-9, 20:1n-9, 24:1n-9) in plasma phospholipids in relation to risk of GDM. This was a case-control study nested in the NICHD Fetal Growth Studies-Singletons (2009-2013), a prospective study of 2,802 low risk pregnant women. A total of 107 GDM cases were ascertained using the Carpenter and Coustan criteria, and 214 non-GDM controls were selected on a 1:2 ratio and individually matched on age, race/ethnicity, and gestational week (GW) of blood collection. Blood samples were collected at GW 10-14, 15-26, 23-31 and 33-39. Spearman’s correlation coefficient was used to assess the association of circulating MUFAs with indices of glucose homeostasis (e.g., insulin, C-peptide, and HOMA-IR). Conditional logistic regression models adjusted for risk factors of GDM including pre-pregnancy BMI were used to assess the associations of circulating MUFAs with subsequent GDM risk. Total MUFAs (p=0.015) and 18:1n-9 (p=0.012) were significantly lower in GDM cases than controls at GW 15-26. 16:1n-7c was significantly higher in GDM cases than controls at GW 10-14 (p=0.008) and 15-26 (p=0.048). Total MUFAs and 18:1n-9 at GW 15-26 were significantly associated with a lower GDM risk; the adjusted ORs (95% CIs) comparing highest vs. lowest quartiles were 0.15 (0.05-0.44) and 0.14 (0.05-0.45), respectively. Total MUFAs and 18:1n-9 at GW10-14 were inversely correlated with insulin, HOMA-IR, c-peptide at GW 15-26. No significant associations were observed for other individual MUFAs at GW 10-14 or 15-26 with GDM risk.

In conclusion, higher plasma concentrations of MUFAs, especially 18:1n-9, at GW 15-26 were prospectively related to a reduced risk of GDM.


K. Tsoi: None. Y. Zhu: None. J. Wu: None. Q. Sun: Consultant; Self; Emavant Solutions GmbH. M. Li: None. S. Hinkle: None. A. Ajjarapu: None. R.C. Ma: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Research Support; Self; AstraZeneca, Bayer AG, Pfizer Inc. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; AstraZeneca. C. Zhang: None.


Eunice Kennedy Shriver National Institute of Child Health and Human Development; American Recovery and Reinvestment Act (HHSN275200800013C, HHSN275200800002I, HHSN27500006, HHSN275200800003IC, HHSN275200800014C, HHSN275200800012C, HHSN275200800028C, HHSN275201000009C, HHSN275201000001Z)

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