Association of Circulating Branched-Chain Amino Acids with Gestational Diabetes Mellitus: A Meta-Analysis

Context: Recently, the relationship between branched-chain amino acids (BCAAs) and diabetes mellitus (DM) has attracted world-wide attention. However, the results related to plasma BCAAs concentrations and gestational diabetes mellitus (GDM) lack statistical power due to the small sample size of a single article. Objectives: This study quantitatively summarized current observational studies to evaluate the association between plasma BCAAs concentration levels and GDM. Methods: A systematic search was performed to select eligible publications using PubMed and EMBASE databases until July 23, 2018. The references of relevant articles were also manually searched. The quality evaluation of included studies was according to the guidelines of the Newcastle-Ottawa Scale (NOS). Data were analyzed with Review Manager 5.3 and STATA 14.0 software. In total, seven articles (including eight studies) involving 432 subjects were included. Results: The results showed that all three-individual plasma BCAAs concentration levels in the GDM group were higher than those in the control group (leucine: SMD = 3.76, 95% CI: 1.70 - 5.82, P (SMD) < 0.001; isoleucine: SMD = 3.15, 95% CI: 1.42 - 4.87, P (SMD) < 0.001; valine: SMD = 2.77, 95% CI: 1.21 - 4.32, P (SMD) = 0.001), and the differences were statistically significant. In addition, subgroup analysis indicated that age, body mass index (BMI), publication year, and ethnicity were positively associated with plasma BCAAs concentrations in GDM. Conclusions: Plasma BCAAs, as potential biomarkers, might be associated with GDM risk, which provides useful information for the prevention and early diagnosis of GDM.