Urinary Peptides Associated Closely with Gestational Diabetes Mellitus.

Zhiying Hu,Mei Hu,Jia Li,Man Zhang,Yaping Tian

doi:10.1155/2020/8880034

Abstract

Gestational diabetes mellitus (GDM) is a common disease of pregnant women, which has a higher incidence in recent years. The purpose of this study is to explore urinary biomarkers that could predict and monitor gestational diabetes mellitus (GDM). Urine samples from 30 normal pregnant women and 78 GDM patients were collected and purified by weak cationic exchange magnetic beads (MB-WCX), then analyzed by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). The urinary peptide signatures of the two groups were compared by BioExplorer software. The potential ability of the differently expressed peptides to distinguish GDM patients from normal pregnant women was evaluated by receiver operating characteristic (ROC) analysis. At last, the differently expressed peptides were identified by liquid chromatography tandem mass spectrometry (LC-MS). There were four differently expressed peptides (m/z 1000.5, 1117.5, 1142.9, and 2022.9) between two groups, which were identified as fragments of urinary albumin, α2-macroglobulin, human hemopexin, and α1-microglobulin, respectively. The diagnostic efficacy of m/z 1142.9 was better than the other peptides. The area under the curve (AUC) of the m/z 1142.9 was 0.690 (95% CI: 0.583-0.796). The discovery of urinary polypeptides provides the possibility for the early prediction of GDM and the monitoring of glucose metabolism in GDM patients by a noninvasive method.

Highlights

Gestational diabetes mellitus (GDM) can increase the rate of miscarriage, lead to fetal growth restriction, fetal malformation, macrosomia, neonatal respiratory distress syndrome, neonatal hypoglycemia, and other adverse prognoses, and significantly increase the probability of type 2 diabetes in mothers and offspring in the long term [1,2,3,4,5]
In order to monitor the glucose metabolism of GDM patients, the fasting plasma glucose (FPG) and glycosylated hemoglobin are currently used in the clinic
Progressive insulin resistance begins in the second trimester and develops further in the third trimester

Summary

Introduction

Gestational diabetes mellitus (GDM) can increase the rate of miscarriage, lead to fetal growth restriction, fetal malformation, macrosomia, neonatal respiratory distress syndrome, neonatal hypoglycemia, and other adverse prognoses, and significantly increase the probability of type 2 diabetes in mothers and offspring in the long term [1,2,3,4,5]. Several studies show that GDM treatment can reduce the incidence of adverse pregnancy outcomes [6,7,8]. In order to monitor the glucose metabolism of GDM patients, the fasting plasma glucose (FPG) and glycosylated hemoglobin are currently used in the clinic. FPG detection can realize the real-time monitoring of glucose metabolism, but it needs repeatedly invasive blood collection operations by nurses. The traumatic operation leads to the poor compliance of GDM patients. Glycosylated hemoglobin can effectively reflect the blood glucose level of GDM patients in the past 1-2 months, irreversible organ damage to pregnant women and fetuses may have occurred

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