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Abstract
Gestational diabetes mellitus (GDM) is a hyperglycaemic imbalance first recognized during pregnancy, and affects up to 22% of pregnancies worldwide, bringing negative maternal–fetal consequences in the short- and long-term. In order to better characterize GDM in pregnant women, 100 blood plasma samples (50 GDM and 50 healthy pregnant control group) were submitted Attenuated Total Reflection Fourier-transform infrared (ATR-FTIR) spectroscopy, using chemometric approaches, including feature selection algorithms associated with discriminant analysis, such as Linear Discriminant Analysis (LDA), Quadratic Discriminant Analysis (QDA) and Support Vector Machines (SVM), analyzed in the biofingerprint region between 1800 and 900 cm−1 followed by Savitzky–Golay smoothing, baseline correction and normalization to Amide-I band (~ 1650 cm−1). An initial exploratory analysis of the data by Principal Component Analysis (PCA) showed a separation tendency between the two groups, which were then classified by supervised algorithms. Overall, the results obtained by Genetic Algorithm Linear Discriminant Analysis (GA-LDA) were the most satisfactory, with an accuracy, sensitivity and specificity of 100%. The spectral features responsible for group differentiation were attributed mainly to the lipid/protein regions (1462–1747 cm−1). These findings demonstrate, for the first time, the potential of ATR-FTIR spectroscopy combined with multivariate analysis as a screening tool for fast and low-cost GDM detection.
Highlights
IntroductionGestational diabetes mellitus (GDM) is a hyperglycaemic imbalance first recognized during pregnancy, and affects up to 22% of pregnancies worldwide, bringing negative maternal–fetal consequences in the short- and long-term
Gestational diabetes mellitus (GDM) is a hyperglycaemic metabolic disorder that first appears during pregnancy and does not meet the criteria for manifest d iabetes[1], it is characterized by glucose intolerance or beta cell dysfunction and insulin resistance, and affects up to 22% of all pregnancies worldwide[2]
ATR-FTIR is considered a valuable tool capable of analysing different types of diseases by measuring biologicalderived samples. We used this technique in order to analyse the specificity, sensitivity and accuracy when differentiating the GDM group
Summary
Gestational diabetes mellitus (GDM) is a hyperglycaemic imbalance first recognized during pregnancy, and affects up to 22% of pregnancies worldwide, bringing negative maternal–fetal consequences in the short- and long-term. Other glycemic markers have been used for the diagnosis of diabetes mellitus (DM), including fructosamine, glycated albumin, hemoglobin A1c (HbA1c), and 1,5-anhydroglucite, each with its own limitation, if we consider cost for countries in d evelopment[4] Despite this approach, several researchers are looking for new possibilities to identify women at risk for GDM, in the first trimester. Individuals with GDM during pregnancy are known to suffer physiological changes, with the appearance of diabetogenic placental hormones (oestrogen and progesterone), placental factors (human placental lactogen), and increased lipids and adipokines including leptin, resistin and visfatin from the first trimester These contribute to the predisposition of metabolic diseases and insulin resistance, obesity and chronic inflammation capable of releasing different pro-inflammatory cytokines and C-reactive proteins (CRP), especially when these women are obese[7]
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