Haslam Danielle E, Li Jun, Liang Liming, Martinez Marijulie, Palacios Cristina, Trak-Fellermeier Maria A, Franks Paul W, Joshipura Kaumudi, Bhupathiraju Shilpa N
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
Metabolites. 2020 Jul 10;10(7):284. doi: 10.3390/metabo10070284.
The oral glucose tolerance test (OGTT) is used to diagnose gestational and other types of diabetes. We examined metabolite changes during an OGTT, and how a comprehensive diet and physical activity intervention may influence these changes in a population of overweight/obese Hispanic pregnant women. Integration of changes in metabolites during an OGTT may help us gain preliminary insights into how glucose metabolism changes during pregnancy. Among women from the Pregnancy and EARly Lifestyle improvement Study (PEARLS), we measured metabolites during a multipoint OGTT (fasting, 30, 60 and 120 min) at early and mid-pregnancy. Metabolite levels were measured by liquid chromatography-mass spectrometry in plasma samples in the lifestyle intervention ( = 13) and control ( = 16) arms of the study. A total of 65 candidate metabolites were selected that displayed changes during an OGTT in previous studies. Paired and unpaired -tests were used to examine differences in Δfast-120 min: (1) at early and mid-pregnancy; and (2) by intervention assignment. We applied principal component analysis (PCA) to identify those metabolites that differed by intervention assignment and OGTT time points. Most of the characteristic changes in metabolites post-OGTT were similar at both gestational time points. PCA identified characteristic metabolite patterns associated with OGTT time points at both early and mid-pregnancy. These metabolites included ketone bodies, tryptophan, acyl carnitines, polyunsaturated fatty acids, and biomarkers related to bile acid, urea cycle, arginine, and proline metabolism. PCA identified distinct Δfast-120 min in fatty acid, acyl carnitine, bile acid, ketone body, and amino acid levels at mid- compared to early pregnancy. Participants in the intervention group did not display mean decreases in Δfast-120 min of several long-chain acyl carnitines that were observed in the control group. These findings provide preliminary insight into metabolites, whose role in increased insulin resistance during pregnancy, should be explored further in future studies.
口服葡萄糖耐量试验（OGTT）用于诊断妊娠期糖尿病和其他类型的糖尿病。我们研究了OGTT期间的代谢物变化，以及全面的饮食和体育活动干预如何影响超重/肥胖的西班牙裔孕妇群体中的这些变化。OGTT期间代谢物变化的整合可能有助于我们初步了解孕期葡萄糖代谢是如何变化的。在妊娠与早期生活方式改善研究（PEARLS）的女性中，我们在妊娠早期和中期的多点OGTT（空腹、30、60和120分钟）期间测量了代谢物。在研究的生活方式干预组（n = 13）和对照组（n = 16）中，通过液相色谱-质谱法测量血浆样本中的代谢物水平。总共选择了65种候选代谢物，这些代谢物在先前的研究中在OGTT期间显示出变化。使用配对和非配对t检验来检查Δ空腹-120分钟的差异：（1）在妊娠早期和中期；（2）按干预分配情况。我们应用主成分分析（PCA）来识别那些因干预分配和OGTT时间点而异的代谢物。OGTT后代谢物的大多数特征性变化在两个妊娠时间点相似。PCA确定了与妊娠早期和中期OGTT时间点相关的特征性代谢物模式。这些代谢物包括酮体、色氨酸、酰基肉碱、多不饱和脂肪酸，以及与胆汁酸、尿素循环、精氨酸和脯氨酸代谢相关的生物标志物。与妊娠早期相比，PCA确定妊娠中期脂肪酸、酰基肉碱、胆汁酸、酮体和氨基酸水平的Δ空腹-120分钟有明显差异。干预组的参与者在几种长链酰基肉碱的Δ空腹-120分钟方面没有显示出如对照组中观察到的平均下降。这些发现为代谢物提供了初步见解，其在孕期胰岛素抵抗增加中的作用应在未来研究中进一步探索。
