Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne 3168, Australia.
Department of Diabetes, Monash Health, Melbourne 3168, Australia.
Int J Mol Sci. 2021 May 24;22(11):5512. doi: 10.3390/ijms22115512.
Gestational diabetes mellitus (GDM) is the fastest growing type of diabetes, affecting between 2 to 38% of pregnancies worldwide, varying considerably depending on diagnostic criteria used and sample population studied. Adverse obstetric outcomes include an increased risk of macrosomia, and higher rates of stillbirth, instrumental delivery, and birth trauma. Metabolomics, which is a platform used to analyse and characterise a large number of metabolites, is increasingly used to explore the pathophysiology of cardiometabolic conditions such as GDM. This review aims to summarise metabolomics studies in GDM (from inception to January 2021) in order to highlight prospective biomarkers for diagnosis, and to better understand the dysfunctional metabolic pathways underlying the condition. We found that the most commonly deranged pathways in GDM include amino acids (glutathione, alanine, valine, and serine), carbohydrates (2-hydroxybutyrate and 1,5-anhydroglucitol), and lipids (phosphatidylcholines and lysophosphatidylcholines). We also highlight the possibility of using certain metabolites as predictive markers for developing GDM, with the use of highly stratified modelling techniques. Limitations for metabolomic research are evaluated, and future directions for the field are suggested to aid in the integration of these findings into clinical practice.
妊娠期糖尿病（GDM）是增长最快的糖尿病类型，影响全球 2%至 38%的妊娠，具体取决于所使用的诊断标准和研究的样本人群而有很大差异。不良的产科结局包括巨大儿的风险增加，以及死产、器械分娩和分娩创伤的发生率更高。代谢组学是一种用于分析和描述大量代谢物的平台，越来越多地用于探索妊娠期糖尿病等心血管代谢疾病的病理生理学。本综述旨在总结 GDM 的代谢组学研究（从开始到 2021 年 1 月），以突出用于诊断的有前景的生物标志物，并更好地了解该疾病相关的代谢途径功能障碍。我们发现，GDM 中最常失调的途径包括氨基酸（谷胱甘肽、丙氨酸、缬氨酸和丝氨酸）、碳水化合物（2-羟基丁酸和 1,5-脱水葡萄糖醇）和脂质（磷脂和溶血磷脂）。我们还强调了使用某些代谢物作为预测标志物来预测 GDM 发展的可能性，使用高度分层的建模技术。评估了代谢组学研究的局限性，并提出了该领域的未来方向，以帮助将这些发现整合到临床实践中。
