Heath Hannah, Luevano Jennifer, Johnson Catherine M, Phelan Suzanne, La Frano Michael R
Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA 93407, USA.
Cal Poly Metabolomics Service Center, California Polytechnic State University, San Luis Obispo, CA 93407, USA.
J Endocr Soc. 2022 Sep 3;6(12):bvac134. doi: 10.1210/jendso/bvac134. eCollection 2022 Oct 26.
Gestational diabetes mellitus (GDM) results in an increased risk of pre- and postpartum health complications for both mother and child. Metabolomics analysis can potentially identify predictive biomarkers and provide insight into metabolic alterations associated with GDM pathogenesis and progression, but few metabolomics studies investigate alterations observed across the first and third trimester. We hypothesize that metabolites altered in first-trimester GDM that remain altered in late pregnancy may best inform interventions. Metabolomic studies comparing plasma and serum metabolite alterations in GDM vs non-GDM pregnancies were retrieved by searching PubMed, Medline, and CINAHL Plus databases. The present scoping review summarizes the metabolites found to be consistently altered throughout the course of GDM and proposes mechanisms that explain how these metabolic perturbations relate to GDM development and progression. Metabolites involved in fatty acid metabolism, reductive carboxylation, branched-chain amino acid metabolism, cell membrane lipid metabolism, purine degradation, and the gut microbiome were found to be altered throughout GDM pregnancies, with many of these pathways showing mechanistic links to insulin resistance, inflammation, and impaired cell signaling. Future studies are required to investigate if normalization of these perturbed pathways can be the targets of interventions.
妊娠期糖尿病（GDM）会增加母婴产前和产后健康并发症的风险。代谢组学分析有可能识别预测性生物标志物，并深入了解与GDM发病机制和进展相关的代谢改变，但很少有代谢组学研究调查孕早期和孕晚期观察到的变化。我们假设，孕早期GDM中发生改变且在妊娠晚期仍保持改变的代谢物可能最有助于指导干预措施。通过检索PubMed、Medline和CINAHL Plus数据库，获取了比较GDM与非GDM妊娠中血浆和血清代谢物变化的代谢组学研究。本综述总结了在GDM病程中持续发生改变的代谢物，并提出了解释这些代谢紊乱如何与GDM发生发展相关的机制。在整个GDM妊娠过程中，参与脂肪酸代谢、还原羧化、支链氨基酸代谢、细胞膜脂质代谢、嘌呤降解和肠道微生物群的代谢物发生了改变，其中许多途径显示出与胰岛素抵抗、炎症和细胞信号传导受损的机制联系。未来需要开展研究，以调查这些紊乱途径的正常化是否可以成为干预目标。
