Serum Metabolites as an Indicator of Developing Gestational Diabetes Mellitus Later in the Pregnancy: A Prospective Cohort of a Chinese Population.

Mengyuan Tian,Shujuan Ma,Xiaolei Wang,Yiping You,Hongzhuan Tan,Jiayue Zhang,Sisi Long,Chuhao Guo,Michaelangela Barbieri

doi:10.1155/2021/8885954

Abstract

Objective Gestational diabetes mellitus (GDM) is a common metabolic disorder with onset during pregnancy. However, the etiology and pathogenesis of GDM have not been fully elucidated. In this study, we used a metabolomics approach to investigate the relationship between maternal serum metabolites and GDM in early pregnancy. Methods A nested case-control study was performed. To establish an early pregnancy cohort, pregnant women in early pregnancy (10‐13+6 weeks) were recruited. In total, 51 patients with GDM and 51 healthy controls were included. Serum samples were analyzed using an untargeted high-performance liquid chromatography mass spectrometry metabolomics approach. The relationships between metabolites and GDM were analyzed by an orthogonal partial least-squares discriminant analysis. Differential metabolites were evaluated using a KEGG pathway analysis. Results A total of 44 differential metabolites were identified between GDM cases and healthy controls during early pregnancy. Of these, 26 significant metabolites were obtained in early pregnancy after false discovery rate (FDR < 0.1) correction. In the GDM group, the levels of L-pyroglutamic acid, L-glutamic acid, phenylacetic acid, pantothenic acid, and xanthine were significantly higher and the levels of 1,5-anhydro-D-glucitol, calcitriol, and 4-oxoproline were significantly lower than those in the control group. These metabolites were involved in multiple metabolic pathways, including those for amino acid, carbohydrate, lipid, energy, nucleotide, cofactor, and vitamin metabolism. Conclusions We identified significant differentially expressed metabolites associated with the risk of GDM, providing insight into the mechanisms underlying GDM in early pregnancy and candidate predictive markers.

Highlights

Gestational diabetes mellitus (GDM), a common metabolic disorder during pregnancy, is defined as glucose intolerance occurring in the second and third trimesters, resulting in varying degrees of hyperglycemia [1]
There were no significant differences in maternal age, gestational age at the time of investigation, gestational age at blood sampling, gravidity, and parity between patients with GDM and controls
Early pregnancy weight, body mass index (BMI), blood pressure (SBP/DBP), and history of GDM were significantly higher in the GDM group than in the control group (p < 0:05)

Summary

Introduction

Gestational diabetes mellitus (GDM), a common metabolic disorder during pregnancy, is defined as glucose intolerance occurring in the second and third trimesters, resulting in varying degrees of hyperglycemia [1]. Owing to the increase in prevalence, negative economic impacts, and adverse health outcomes of GDM, research focused on GDM has increased. Women who have had GDM have an increased risk of type 2 diabetes mellitus (T2DM), metabolic syndrome, fatty liver, and cardiovascular disease [7,8,9]. The risk of impaired glucose tolerance, diabetes, hypertension, obesity, and coronary heart disease in the offspring of women with a history of GDM may be significantly elevated [1, 10, 11]

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Conclusion