Association of serum biomarkers of dietary purine intake with glycaemic control and risk of preterm birth: two prospective cohort studies among pregnant women
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: To examine serum purine metabolites as biomarkers of maternal dietary purine intake and their associations with glycaemic control and preterm birth during pregnancy. METHODS: We included 1480 pregnant Chinese women with gestational diabetes mellitus (GDM) from the Westlake Precision Birth Cohort (WeBirth) at mid-pregnancy, divided into discovery (n = 1230) and internal validation (n = 250) subcohorts. Linear regression was used to assess associations between serum metabolites, dietary purine intake, and continuous glucose monitoring (CGM) metrics. A purine score was developed and evaluated for associations with glycaemic control and preterm birth, with replication in 936 pregnant women from the Tongji-Huaxi-Shuangliu Birth Cohort (THSBC). FINDINGS: Serum purine level was associated with dietary purine intake and with the mean of daily difference (β = 0.096 [95% CI, 0.038, 0.15]). The association between higher serum purine and preterm birth risk in the WeBirth cohort (OR = 1.29 [95% CI, 1.06, 1.52]) was replicated in the THSBC cohort. Early-pregnancy serum purine also predicted GDM risk (OR = 1.38 [95% CI, 1.13, 1.63]) in the THSBC. A purine score comprising purine, adenine, 6-O-methylguanine, and uric acid showed consistent associations with glycaemic variability and preterm birth across both cohorts. INTERPRETATION: Reflecting dietary purine intake, serum purine level and purine score are associated with greater glycaemic variability and higher preterm birth risk. Monitoring dietary purine intake may improve glycaemic control in GDM and prevent pregnancy complications. FUNDING: National Key R&D Program of China; National Natural Science Foundation of China; Zhejiang Provincial Key Laboratory Construction Project; Sichuan Provincial Natural Science Foundation.
Source: EBioMedicine
Institutions: Fudan University, Westlake University, Affiliated Hangzhou First People's Hospital, Westlake University, School of Medicine, National Medical Products Administration, Sichuan University, West China Second University Hospital of Sichuan University, Huazhong University of Science and Technology, Hangzhou Normal University, Hangzhou Women’s Hospital, Maternal and Child Health Hospital of Sichuan Province, Women's Hospital, School of Medicine, Zhejiang University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $5,780
Funders: National Natural Science Foundation of China, National University's Basic Research Foundation of China, Natural Science Foundation of Sichuan Province, Sichuan Province Science and Technology Support Program, National Key Research and Development Program of China, Fundamental Research Funds for the Central Universities
OpenAlex ID: W7161951602