National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Respiratory and Critical Care Medicine, Ganzhou People's Hospital (Ganzhou Hospital Affiliated to Nanchang University/Nanfang Medical University), Ganzhou, Jiangxi Province, China.
Front Public Health. 2023 Jul 4;11:1217237. doi: 10.3389/fpubh.2023.1217237. eCollection 2023.
Gestational diabetes mellitus (GDM) stands as a prevalent obstetric complication bearing consequential health implications for both mother and child. While existing studies have probed the alterations in acylcarnitines during GDM, an updated systematic meta-analysis is needed to consolidate these findings. Hence, this study endeavours to furnish a comprehensive systematic review and meta-analysis delineating the association between acylcarnitines and GDM, aimed at bolstering diagnostic accuracy and preventive measures against GDM.
To extract pertinent studies for this meta-analysis, we meticulously scoured databases such as PubMed, Web of Science, Embase, and Cochrane Library up until May 2023. The inclusion criteria were studies contrasting plasma metabolomics between two cohorts: women diagnosed with GDM and normoglycemic pregnant women. Weighted mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using random-effects models. The index was employed to quantify heterogeneity amongst the studies. All meta-analyses were executed using Stata version 12.0.
Our meta-analysis included eight studies encompassing 878 pregnant women. The analysis disclosed that relative to normoglycemic pregnant women, women with GDM exhibited significantly elevated levels of Short-Chain Acylcarnitines (SCAC) (SMD: 0.19, 95% CI: 0.02-0.36, = 71.3%). No substantial difference was discerned in fasting total carnitine levels (SMD: 0.15, 95% CI: -0.16-0.31, = 68.2%), medium-chain acylcarnitines (MCAC) (SMD: 0.08, 95% CI: -0.02-0.36, = 79.0%), and long-chain acylcarnitines (LCAC) (SMD: 0.04, 95% CI: -0.06-0.15, = 0%). Neither funnel plot assessment nor Egger's regression and Begg's rank correlation tests indicated any evidence of publication bias.
Our meta-analysis suggests that elevated levels of SCAC may heighten the risk of GDM onset. Given GDM's deleterious impact on pregnant women and their offspring, these findings underscore the clinical imperative of managing this condition. Early surveillance of plasma metabolomic profiles, particularly serum acylcarnitine concentrations, may equip clinicians with a valuable tool for timely diagnosis and intervention in GDM.
妊娠糖尿病（GDM）是一种常见的产科并发症，对母婴健康都有重要影响。尽管已有研究探讨了 GDM 期间酰基辅酶 A 的变化，但仍需要进行更新的系统荟萃分析来综合这些发现。因此，本研究旨在提供全面的系统综述和荟萃分析，阐述酰基辅酶 A 与 GDM 之间的关联，以提高 GDM 的诊断准确性和预防措施。
为了进行这项荟萃分析，我们精心搜索了数据库，如 PubMed、Web of Science、Embase 和 Cochrane Library，截至 2023 年 5 月。纳入标准为比较两组之间血浆代谢组学的研究：诊断为 GDM 的妇女和血糖正常的孕妇。使用随机效应模型计算加权均数差（SMD）和 95%置信区间（CI）。使用 I 2 指数来量化研究之间的异质性。所有荟萃分析均使用 Stata 版本 12.0 执行。
我们的荟萃分析纳入了 8 项共 878 名孕妇的研究。分析表明，与血糖正常的孕妇相比，患有 GDM 的孕妇的短链酰基辅酶 A（SCAC）水平显著升高（SMD：0.19，95%CI：0.02-0.36， = 71.3%）。空腹总肉碱水平无显著差异（SMD：0.15，95%CI：-0.16-0.31， = 68.2%）、中链酰基辅酶 A（MCAC）（SMD：0.08，95%CI：-0.02-0.36， = 79.0%）和长链酰基辅酶 A（LCAC）（SMD：0.04，95%CI：-0.06-0.15， = 0%）。漏斗图评估、Egger 回归和 Begg 秩相关检验均未提示存在发表偏倚的证据。
我们的荟萃分析表明，SCAC 水平升高可能会增加 GDM 发病的风险。鉴于 GDM 对孕妇及其后代的不良影响，这些发现强调了管理这种疾病的临床重要性。早期监测血浆代谢组学谱，特别是血清酰基辅酶 A 浓度，可能为临床医生提供一种有价值的工具，用于及时诊断和干预 GDM。
