Increased fecal indole concentration in women with gestational diabetes: a pilot study
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SHORT COMMUNICATION
Increased fecal indole concentration in women with gestational diabetes: a pilot study Marija Trajkova1 · Katja Molan1 · Maja Zugan1 · Jerneja Ambrožič Avguštin1 · Marjanca Starčič Erjavec1 · Darja Žgur Bertok1 · Draženka Pongrac Barlovič2,3 Received: 9 October 2020 / Accepted: 31 October 2020 © Springer-Verlag Italia S.r.l., part of Springer Nature 2020
Introduction
Methods
Gestational diabetes (GDM) is characterized by insufficient insulin secretion and hyperglycemia during pregnancy that is accompanied by changes in gut microbiota composition. Gut microbiota mediates its effects on the host primarily through its metabolites. Recently, in vitro studies suggested that indole, produced by the gut microbiota from dietary tryptophan, may have a major impact on host glucose metabolism by modulating glucagon-like peptide-1 (GLP-1) secretion from enteroendocrine L-cells [1]. In this study, we hypothesized that in women with GDM, fecal indole content will differ from that in women without GDM. Therefore, fecal indole concentrations in the second trimester of pregnancy in women with GDM, in women without GDM and in healthy age-matched non-pregnant controls were analyzed.
This was an observational pilot study that included 55 participants. After the GDM screening in the 24th–28th week of gestation at the University Medical Centre Ljubljana, 35 GDM women and 9 non-GDM controls were recruited successively. GDM was diagnosed according to the IADPSG criteria. Another control group of 11 healthy non-pregnant individuals was formed from among motivated workers at the Biotechnical faculty. After inclusion, women collected fecal sample and immediately stored it in the domestic refrigerator. Sample was collected by technical staff and transported to the laboratory within the next 24–48 h. Fecal indole extraction and quantification was described previously [2]. Briefly, fecal samples (250 mg) were suspended in 750 µL 70% ethanol and vortexed at maximum speed. After 10 min incubation at 70 °C the samples were again vortexed and centrifuged for 20 min at 40 °C. The supernatants were collected. Six known concentrations of indole (0–300 mM) were used to establish a standard curve (Fig. 1a). Standards of known indole concentrations and unknown samples (tested in triplicate) were incubated with Kovács reagent and measured spectrophotometrically. The measured absorptions of unknown samples were plotted against known indole concentrations. Clinical and laboratory data of the included GDM women, who were all treated non-pharmacologically throughout the pregnancy, were obtained during regular visits at a diabetologist. HOMA-IR index, a measure of insulin resistance, was calculated according to the formula: fasting insulin concentration*fasting glucose concentration/22.5.
Marija Trajkova and Katja Molan have contributed equally to the work. This article belongs to the topical collection Pregnancy and Diabetes, managed by Antonio Secchi and Marina Scavini. * Draženka Pongrac Barlovič [email protected] 1
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