循环苯丙氨酸与妊娠期糖尿病患者胰岛素标志物受损的时间风险之间的关联。

The association between circulating phenylalanine and the temporal risk of impaired insulin markers in gestational diabetes mellitus.

作者信息

Wu Hao, Wang Qiong, Chen Yanmin, Chen Danqing

机构信息

Department of Obstetrics Central Laboratory, Women's Hospital School of Medicine Zhejiang University, China.

Department of Maternity Inpatient, Women's Hospital School of Medicine Zhejiang University, China.

出版信息

Mol Genet Metab Rep. 2024 Jun 14;40:101090. doi: 10.1016/j.ymgmr.2024.101090. eCollection 2024 Sep.

DOI:10.1016/j.ymgmr.2024.101090

PMID:38974841

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11227027/

Abstract

BACKGROUND

We aimed to contrast plasma amino acid concentrations in pregnant women with Gestational Diabetes Mellitus (GDM) to those without, to analyze the link between plasma amino acid concentrations, GDM, insulin resistance, and insulin secretion at 24-28 weeks of gestation.

METHODS

The research employed a retrospective case-control study design at a single center. Basic demographic and laboratory data were procured from the hospital's case system. The study encompassed seventy women without gestational diabetes mellitus (GDM) and thirty-five women with GDM matched in a 1-to-2 ratio for age and pre-pregnancy BMI. Utilizing high-performance liquid chromatography-mass spectrometry (HPLC-MS), peripheral fasting plasma amino acid concentrations in these women, during mid-pregnancy, were duly measured. We carefully evaluated the significant differences in the quantitative data between the two groups and developed linear regression models to assess the independent risk factors affecting insulin resistance and insulin secretion.

RESULTS

Significant variations in insulin secretion and resistance levels distinguished GDM Group from the non-GDM group at three distinct time points, alongside relatively elevated serum Glycosylated Hemoglobin (HbA1c) levels. Triglycerides (TG) were also significantly increased in those with GDM during adipocytokine observations. Apart from glutamic acid and glutamine, the concentrations of the remaining 16 amino acids were notably increased in GDM patients, including all branched chain amino acids(BCAAs) and aromatic amino acids(AAAs). Ultimately, it was ascertained that fasting serum phenylalanine levels were independent risk factors affecting insulin resistance index and insulin secretion at various phases.

CONCLUSIONS

Various fasting serum amino acid levels are markedly increased in patients with GDM, specifically phenylalanine, which may play role in insulin resistance and secretion.

摘要

背景

我们旨在对比患有妊娠期糖尿病（GDM）的孕妇与未患该病孕妇的血浆氨基酸浓度，以分析妊娠24 - 28周时血浆氨基酸浓度、GDM、胰岛素抵抗和胰岛素分泌之间的联系。

方法

本研究在单一中心采用回顾性病例对照研究设计。基本人口统计学和实验室数据从医院病例系统中获取。该研究纳入了70名无妊娠期糖尿病（GDM）的女性和35名患有GDM的女性，年龄和孕前BMI按1:2的比例匹配。利用高效液相色谱 - 质谱联用仪（HPLC - MS），适时测量了这些女性妊娠中期外周空腹血浆氨基酸浓度。我们仔细评估了两组定量数据的显著差异，并建立线性回归模型以评估影响胰岛素抵抗和胰岛素分泌的独立危险因素。

结果

在三个不同时间点，GDM组与非GDM组在胰岛素分泌和抵抗水平上存在显著差异，同时糖化血红蛋白（HbA1c）水平相对升高。在脂肪细胞因子观察期间，GDM患者的甘油三酯（TG）也显著升高。除谷氨酸和谷氨酰胺外，GDM患者中其余16种氨基酸的浓度显著升高，包括所有支链氨基酸（BCAAs）和芳香族氨基酸（AAAs）。最终确定，空腹血清苯丙氨酸水平是影响各阶段胰岛素抵抗指数和胰岛素分泌的独立危险因素。