The Associations between Maternal Serum Aspartame and Sucralose and Metabolic Health during Pregnancy

Objective: We aimed to investigate the associations between maternal serum aspartame/sucralose levels and metabolic health during pregnancy. Methods: A nested population-based case-control study was conducted in 109 women with and without gestational diabetes mellitus (GDM). Serum aspartame and sucralose levels were assessed using an ultraperformance liquid chromatography coupled to a tandem mass spectrometry system. Results: We detected the presence of circulating aspartame and sucralose in all participants at fasting. No differences in serum aspartame or sucralose levels were observed between GDM and non-GDM groups. In the fully-adjusted linear regression models, serum aspartame levels were positively associated with insulin resistance index, total cholesterol, and LDL cholesterol. In the fully-adjusted logistic regression models, higher serum aspartame levels were positively associated with elevated HbA1c, insulin resistance, hypercholesterolemia, and hyper-LDL cholesterolemia. In the GDM group, the significant associations between higher serum aspartame levels and elevated HbA1c, insulin resistance, and hypo-HDL cholesterolemia persisted, while positive associations were found between higher serum aspartame levels and insulin resistance and hyper-LDL cholesterolemia in the non-GDM group. Serum sucralose levels were negatively associated with HbA1c. Conclusions: The study found that maternal serum aspartame levels were positively associated with insulin resistance index, total cholesterol, and LDL cholesterol during pregnancy. This finding provides the different effects of specific NNS on metabolic health during pregnancy.