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妊娠期糖尿病的代谢谱可揭示用于预测不良新生儿结局的新型生物标志物。

Metabolic profiles in gestational diabetes mellitus can reveal novel biomarkers for prediction of adverse neonatal outcomes.

作者信息

Yin Xiaoxiao, Yu Tingting, Jiang Dongmei, Shan Chunjian, Xia Jiaai, Su Min, Zhang Min, Chen Ling, Zhong Hong, Cui Xianwei, Ji Chenbo

机构信息

Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, Jiangsu, China.

School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.

出版信息

Front Pediatr. 2024 Aug 21;12:1432113. doi: 10.3389/fped.2024.1432113. eCollection 2024.

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) significantly affects the fetal metabolic environment, elevating risks of neonatal hypoglycemia and macrosomia. Metabolomics offers promising avenues for early prediction and diagnosis of GDM and associated adverse offspring outcomes.

METHODS

This study analyzed serum samples from pregnant women diagnosed with GDM at 24 to 28 weeks of gestation using untargeted metabolomics. We monitored the health outcomes of their offspring to explore the correlation between initial serum metabolite profiles and subsequent health outcomes, to uncover the predictive markers for hypoglycemia and macrosomia in these offspring.

RESULTS

Out of 200 participants, 154 had normal newborns, 33 had offspring with hypoglycemia, and 19 had offspring with macrosomia. From 448 identified metabolites, 66 showed significant differences in cases of hypoglycemia, and 45 in macrosomia. A panel of serum metabolite biomarkers achieved Area Under the Curve (AUC) values of 0.8712 for predicting hypoglycemia and 0.9434 for macrosomia.

CONCLUSION

The study delineated metabolic disruptions in GDM during 24-28 weeks of gestation and pinpointed biomarkers capable of forecasting adverse neonatal outcomes. These findings could inform GDM management strategies and minimize the incidence of such outcomes.

摘要

背景

妊娠期糖尿病(GDM)显著影响胎儿代谢环境,增加新生儿低血糖和巨大儿的风险。代谢组学为GDM及相关不良后代结局的早期预测和诊断提供了有前景的途径。

方法

本研究使用非靶向代谢组学分析了妊娠24至28周被诊断为GDM的孕妇的血清样本。我们监测了其后代的健康结局,以探索初始血清代谢物谱与后续健康结局之间的相关性,从而发现这些后代低血糖和巨大儿的预测标志物。

结果

在这200名参与者中,154名新生儿正常,33名后代患有低血糖,19名后代患有巨大儿。在448种已鉴定的代谢物中,66种在低血糖病例中显示出显著差异,45种在巨大儿病例中显示出显著差异。一组血清代谢物生物标志物预测低血糖的曲线下面积(AUC)值为0.8712,预测巨大儿的AUC值为0.9434。

结论

该研究描绘了妊娠24 - 28周期间GDM的代谢紊乱情况,并确定了能够预测新生儿不良结局的生物标志物。这些发现可为GDM管理策略提供参考,并尽量减少此类结局的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d01/11371726/bb16f6479f40/fped-12-1432113-g001.jpg

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