Metabolic Research Laboratories and MRC Metabolic Diseases Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Box 289, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
Mol Omics. 2019 Dec 2;15(6):420-430. doi: 10.1039/c9mo00117d.
Gestational diabetes (GDM), a common pregnancy complication associated with obesity and long-term health risks, is usually diagnosed at approximately 28 weeks of gestation. An understanding of lipid metabolism in women at risk of GDM could contribute to earlier diagnosis and treatment. We tested the hypothesis that altered lipid metabolism at the beginning of the second trimester in obese pregnant women is associated with a diagnosis of GDM. Plasma samples from 831 participants (16-45 years, 15-18 weeks gestation, BMI ≥ 30) from the UPBEAT study of obese pregnant women were used. The lipid, sterol and glyceride fraction was isolated and analysed in a semi-quantitative fashion using direct infusion mass spectrometry. A combination of uni-, multi-variate and multi-variable statistical analyses was used to identify candidate biomarkers in plasma associated with a diagnosis of GDM (early third trimester; IADPSG criteria). Multivariable adjusted analyses showed that participants who later developed GDM had a greater abundance of several triglycerides (48:0, 50:1, 50:2, 51:5, 53:4) and phosphatidylcholine (38:5). In contrast sphingomyelins (32:1, 41:2, 42:3), lyso-phosphatidylcholine (16:0, 18:1), phosphatidylcholines (35:2, 40:7, 40:10), two polyunsaturated triglycerides (46:5, 48:6) and several oxidised triglycerides (48:6, 54:4, 56:4, 58:6) were less abundant. We concluded that both lipid and triglyceride metabolism were altered at least 10 weeks before diagnosis of GDM. Further investigation is required to determine the functional consequences of these differences and the mechanisms by which they arise.
妊娠期糖尿病（GDM）是一种常见的妊娠并发症，与肥胖和长期健康风险有关，通常在妊娠约 28 周时诊断。了解 GDM 高危妇女的脂质代谢情况有助于早期诊断和治疗。我们检验了这样一个假设，即在肥胖孕妇妊娠中期开始时发生的脂质代谢改变与 GDM 的诊断有关。该研究使用了 UPBEAT 肥胖孕妇研究中 831 名参与者（16-45 岁，15-18 周妊娠，BMI≥30）的血浆样本。采用直接进样质谱法对半定量方式分离和分析脂质、甾醇和甘油酯部分。采用单变量、多变量和多变量统计分析相结合的方法，鉴定与 GDM 诊断相关的候选生物标志物（早三期末；IADPSG 标准）。多变量调整分析显示，随后发生 GDM 的参与者具有几种甘油三酯（48:0、50:1、50:2、51:5、53:4）和磷脂酰胆碱（38:5）的丰度更高。相比之下，神经鞘磷脂（32:1、41:2、42:3）、溶血磷脂酰胆碱（16:0、18:1）、磷脂酰胆碱（35:2、40:7、40:10）、两种多不饱和甘油三酯（46:5、48:6）和几种氧化甘油三酯（48:6、54:4、56:4、58:6）的丰度较低。我们得出结论，至少在 GDM 诊断前 10 周，脂质和甘油三酯代谢就发生了改变。需要进一步研究以确定这些差异的功能后果以及它们产生的机制。
