Mass Spectrometry Centre, China-Canada-New Zealand Joint Laboratory of Maternal and Foetal Medicine, Chongqing Medical University, Chongqing, China; Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Mass Spectrometry Centre, China-Canada-New Zealand Joint Laboratory of Maternal and Foetal Medicine, Chongqing Medical University, Chongqing, China; Institute of Life Sciences, Chongqing Medical University, Chongqing, China.
Clin Chim Acta. 2017 Dec;475:116-127. doi: 10.1016/j.cca.2017.10.019. Epub 2017 Oct 21.
Gestational diabetes mellitus (GDM) is a form of diabetes that is first diagnosed during pregnancy in the absence of existing type 1 or type 2 diabetes. Early screening tools for GDM are currently unavailable, but metabolomics is a promising approach for detecting biomarkers of GDM. This review evaluates recent GDM studies employing metabolomic techniques, highlighting the challenges in those studies and envisions the future directions for metabolomic study of GDM. A diverse range of predictive markers and dysregulated metabolic pathways have been associated with the pathogenesis of GDM, but these findings have lacked reproducibility among studies. The case-control study design has been most frequently employed in the studies of GDM, and most of them used specimens acquired in mid-pregnancy. However, this approach might not be adequate to recognise the complexity of the condition. The sample size in some of the studies is limited, and this may result in findings from a participant set that is not representative of the general population. Therefore, we propose that future metabolomic studies pertaining to GDM use a cross-platform approach employing unified diagnostic criteria, a longitudinal cohort, and innovative data processing methods to allow for full-scale identification and comprehensive coverage of the metabolome. In addition, the relationship between the exposure to environmental chemicals such as endocrine disruptors and the development of GDM should be further investigated in future studies.
妊娠期糖尿病(GDM)是一种在妊娠期间首次诊断出的糖尿病,无 1 型或 2 型糖尿病的既往病史。目前尚缺乏 GDM 的早期筛查工具,但代谢组学是检测 GDM 生物标志物的一种很有前途的方法。本综述评估了最近使用代谢组学技术的 GDM 研究,强调了这些研究中的挑战,并展望了代谢组学研究 GDM 的未来方向。多种预测标志物和失调的代谢途径与 GDM 的发病机制有关,但这些发现缺乏研究间的可重复性。病例对照研究设计在 GDM 的研究中最常被采用,而且大多数研究都使用了妊娠中期获得的标本。然而,这种方法可能不足以识别该疾病的复杂性。一些研究的样本量有限,这可能导致研究对象集的结果不能代表一般人群。因此,我们建议未来关于 GDM 的代谢组学研究采用跨平台方法,采用统一的诊断标准、纵向队列和创新的数据处理方法,以实现对代谢组的全面识别和全面覆盖。此外,应在未来的研究中进一步探讨环境化学物质(如内分泌干扰物)暴露与 GDM 发展之间的关系。