Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, China.
Department of Genetic and Metabolic Diseases, The Children's Hospital, School of Medicine, Zhejiang University, No.1, Xueshi Road, Shangchen District, Hangzhou, China.
J Diabetes Res. 2020 Aug 11;2020:4085757. doi: 10.1155/2020/4085757. eCollection 2020.
The metabolism of three major nutrients (sugar, lipid, and protein) will change during pregnancy, especially in the second trimester. The present study is aimed at evaluating carnitine alteration in fatty acid metabolism in the second trimester of pregnancy and the correlation between carnitine and GDM.
450 pregnant women were recruited in the present prospective study. Metabolic profiling of 31 carnitines was detected by LC-MS/MS in these women. Correlation between carnitine metabolism and maternal and neonatal complication with GDM was analyzed.
We found the levels of 7 carnitines increased in age > 35, BMI ≥ 30, weight gain > 20 kg, and ART pregnant groups, but the level of free carnitine (C0) decreased. Nine carnitines were specific metabolites of GDM. Prepregnancy BMI, weight gain, and carnitines (C0, C3, and C16) were independent risk factors associated with GDM and related macrosomia. C0 was negatively correlated with FBG, LDL, TG, and TC. A nomogram was developed for predicting macrosomia in GDM based on carnitine-related metabolic variables.
The carnitine metabolism in the second trimester is abnormal in GDM women. The dysfunction of carnitine metabolism is closely related to the abnormality of blood lipid and glucose in GDM. Carnitine metabolism abnormality could predict macrosomia complicated with GDM.
三种主要营养素（糖、脂和蛋白质）的代谢在妊娠期间会发生变化，尤其是在妊娠中期。本研究旨在评估妊娠中期脂肪酸代谢中肉碱的变化以及肉碱与 GDM 的相关性。
本前瞻性研究纳入了 450 名孕妇。通过 LC-MS/MS 检测这些妇女的 31 种肉碱的代谢特征。分析了肉碱代谢与伴有 GDM 的母亲和新生儿并发症之间的相关性。
我们发现，在年龄>35 岁、BMI≥30、体重增加>20kg 和 ART 妊娠组中，7 种肉碱的水平升高，但游离肉碱（C0）的水平降低。9 种肉碱是 GDM 的特异性代谢物。孕前 BMI、体重增加和肉碱（C0、C3 和 C16）是与 GDM 相关的巨大儿的独立危险因素。C0 与 FBG、LDL、TG 和 TC 呈负相关。基于肉碱相关代谢变量，开发了一个预测 GDM 巨大儿的列线图。
GDM 妇女妊娠中期的肉碱代谢异常。肉碱代谢功能障碍与 GDM 患者血脂和血糖异常密切相关。肉碱代谢异常可预测伴有 GDM 的巨大儿。
