Editors' ChoiceMetabolism

Who knows best—your mother or her microbiome?

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Science Translational Medicine  15 Jun 2016:
Vol. 8, Issue 343, pp. 343ec96
DOI: 10.1126/scitranslmed.aag1875

Indicators of maternal health during pregnancy, including maternal weight gain, are important predictors of the long-term health of both mothers and their offspring. Although some women easily achieve appropriate weight gain targets in pregnancy, for others it is a constant struggle to avoid becoming overweight or progressing to obesity. Metabolic hormones play an important role, but now Gomez-Arango and colleagues in the SPRING (Study of PRobiotics IN prevention of Gestational diabetes) trial group have identified an important interaction between the hormones and the maternal microbiome that shapes the final outcome.

Although it is known that the microbiome changes during pregnancy and that specific microbiome alterations may predispose to obesity and diabetes, it was not clear whether these factors could be connected. In their study of 29 overweight and 41 obese women during early pregnancy, the authors identified several alterations in the microbiome of obese women. These differences included a tendency towards decreased microbial diversity in the more obese women. Increasing obesity and insulin resistance were related to increased relative abundance of Actinobacteria and specifically the genus Collinsella, which has been associated with Type 2 diabetes. Additional alterations included increased producers of butyrate, a potential energy substrate (Coprococcus, Lachnospiraceae, and Ruminococcaceae). These bacteria, in concert with the Bacteroidaceae/Prevotella ratio, also affected the regulation of leptin and ghrelin, which are the most well known controllers of appetite and food intake.

Further studies are needed to determine whether the maternal diet and weight gain alter the microbiome or vice versa, or whether they are coregulated. In addition, inclusion of normal weight pregnant women would further clarify these relationships. Such studies will help determine the role of the microbiome as a biomarker of metabolic dysfunction and as a potential target for intervention, all of which should improve the health of mothers and children.

L. F. Gomez-Arango et al., Connections between the gut microbiome and metabolic hormones in early pregnancy in overweight and obese women. Diabetes 10.2337/db16-0278 (2016). [Abstract]

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