Zhou Jing, Yu Jie, Ren Jing, Ren Yaolin, Zeng Yuan, Wu Yifan, Zhang Qian, Xiao Xinhua
Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Diabetes Research Center of Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences, Beijing, 100730, China.
Rev Endocr Metab Disord. 2025 Apr;26(2):205-222. doi: 10.1007/s11154-024-09934-5. Epub 2024 Nov 27.
Gestational diabetes mellitus (GDM) is a common complication of pregnancy that has short- and long-term adverse effects. Therefore, further exploration of the pathophysiology of GDM and related biomarkers is important. In this study, we performed a systematic review and meta-analysis to investigate the associations between metabolites in blood detected via metabolomics techniques and the risk of GDM and to identify possible biomarkers for predicting the occurrence of GDM. We retrieved case‒control and cohort studies of metabolomics and GDM published in PubMed, Embase, and Web of Science through March 29, 2024; extracted metabolite concentrations, odds ratios (ORs), or relative risks (RRs); and evaluated the integrated results with metabolites per-SD risk estimates and 95% CIs for GDM. We estimated the results via the random effects model and the inverse variance method. Our study is registered in PROSPERO (CRD42024539435). We included a total of 28 case‒control and cohort studies, including 17,370 subjects (4,372 GDM patients and 12,998 non-GDM subjects), and meta-analyzed 67 metabolites. Twenty-five of these metabolites were associated with GDM risk. Some amino acids (isoleucine, leucine, valine, alanine, aspartate, etc.), lipids (C16:0, C18:1n-9, C18:1n-7, lysophosphatidylcholine (LPC) (16:0), LPC (18:0), and palmitoylcarnitine), and carbohydrates and energy metabolites (glucose, pyruvate, lactate, 2-hydroxybutyrate, 3-hydroxybutyrate) were discovered to be associated with increased GDM risk (hazard ratio 1.06-2.77). Glutamine, histidine, C14:0, and sphingomyelin (SM) (34:1) were associated with lower GDM risk (hazard ratio 0.75-0.84). These findings suggest that these metabolites may play essential roles in GDM progression, and serve as biomarkers, contributing to the early diagnosis and prediction of GDM.
妊娠期糖尿病（GDM）是一种常见的妊娠并发症，具有短期和长期的不良影响。因此，进一步探索GDM的病理生理学及相关生物标志物具有重要意义。在本研究中，我们进行了一项系统综述和荟萃分析，以研究通过代谢组学技术检测的血液中的代谢物与GDM风险之间的关联，并确定预测GDM发生的潜在生物标志物。我们检索了截至2024年3月29日在PubMed、Embase和Web of Science上发表的关于代谢组学和GDM的病例对照研究及队列研究；提取了代谢物浓度、比值比（OR）或相对风险（RR）；并使用代谢物每标准差风险估计值和GDM的95%置信区间评估综合结果。我们通过随机效应模型和逆方差法估计结果。我们的研究已在PROSPERO（CRD42024539435）注册。我们总共纳入了28项病例对照研究和队列研究，包括17370名受试者（4372名GDM患者和12998名非GDM受试者），并对67种代谢物进行了荟萃分析。其中25种代谢物与GDM风险相关。发现一些氨基酸（异亮氨酸、亮氨酸、缬氨酸、丙氨酸、天冬氨酸等）、脂质（C16:0、C18:1n-9、C18:1n-7、溶血磷脂酰胆碱（LPC）（16:0）、LPC（18:0）和棕榈酰肉碱）以及碳水化合物和能量代谢物（葡萄糖、丙酮酸、乳酸、2-羟基丁酸、3-羟基丁酸）与GDM风险增加相关（风险比1.06-2.77）。谷氨酰胺、组氨酸、C14:0和鞘磷脂（SM）（34:1）与较低的GDM风险相关（风险比0.75-0.84）。这些发现表明，这些代谢物可能在GDM进展中起重要作用，并可作为生物标志物，有助于GDM的早期诊断和预测。
