Preconception Micronutrient Supplementation Reduced Circulating Branched Chain Amino Acids at 12 Weeks Gestation in an Open Trial of Guatemalan Women Who Are Overweight or Obese

Sarah J Borengasser, Peter R Baker 2nd, Mattie E Kerns, Leland V Miller, Alexandra P Palacios, Jennifer F Kemp, Jamie E Westcott, Seth D Morrison, Teri L Hernandez, Ana Garces, Lester Figueroa, Jacob E Friedman, K Michael Hambidge, Nancy F Krebs, Sarah J Borengasser, Peter R Baker 2nd, Mattie E Kerns, Leland V Miller, Alexandra P Palacios, Jennifer F Kemp, Jamie E Westcott, Seth D Morrison, Teri L Hernandez, Ana Garces, Lester Figueroa, Jacob E Friedman, K Michael Hambidge, Nancy F Krebs

Abstract

Elevated branched chain amino acids (BCAAs: valine, leucine, and isoleucine) are well-established biomarkers of obesity-associated insulin resistance (IR). Mounting evidence suggests that low- and middle-income countries are suffering from a "double burden" of both undernutrition (growth stunting) and overnutrition (obesity) as these countries undergo a "nutrition transition". The purpose of this study was to examine if pre-pregnancy body mass index (BMI, kg/m²) and a daily lipid-based micronutrient supplement (LNS, Nutriset) would lead to cross-sectional differences in circulating levels of branched chain amino acids (BCAAs) in Guatemalan women experiencing short stature during early pregnancy. Using data from an ongoing randomized controlled trial, Women First, we studied women who were normal weight (NW, BMI range for this cohort = 20.1⁻24.1 kg/m²) or overweight/obese (OW/OB, BMI range for this cohort = 25.6⁻31.9 kg/m²), and divided into two groups: those who received daily LNS ≥ 3 months prior to conception through 12 weeks gestation (+LNS), or no LNS (-LNS) (n = 9⁻10/group). BCAAs levels were obtained from dried blood spot card samples (DBS) assessed at 12 weeks gestation. DBS cards provide a stable, efficient, and reliable means of collecting, transporting, and storing blood samples in low resource or field settings. Circulating maternal leptin, adiponectin, and insulin were determined by immunoassays from serum samples collected at 12 weeks gestation. We found maternal pre-pregnancy body mass index (ppBMI) was associated with higher circulating BCAAs (r² = 0.433, p = 0.002) and higher leptin/adiponectin ratio (r = 0.466, p = 0.044) in -LNS mothers at 12 weeks gestation. +LNS mothers demonstrated no correlations between BCAAs or leptin/adiponectin ratio across ppBMI suggesting LNS may be effective at improving metabolic status in OW/OB mothers during early pregnancy.

Keywords: branched chain amino acids; dried blood spot cards; micronutrients; obesity; pregnancy.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Branched chained amino acids levels (A) leucine + isoleucine and (B) valine. Data are expressed as mean ± SEM. Statistical differences for branched chain amino acid levels were determined using two-way ANOVA to examine differences due to maternal lipid-based micronutrient supplementation (LNS) and pre-pregnancy BMI category. Tukey’s post hoc testing was performed for multiple comparisons. Statistical significance was set at p ≤ 0.05. Different letter superscripts denote significance.
Figure 2
Figure 2
Comparative regression analysis was used to assess associations between branched chain amino acid concentrations and maternal pre-pregnancy BMI for (A) total branched amino acids, (B) valine, and (C) isoleucine and leucine in mothers who consumed LNS (n = 19 mothers) or no consumption of LNS (n = 20 mothers) at 12 weeks gestation. Significance was set at p ≤ 0.05.

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