Metabolic profiling of gestational diabetes in obese women during pregnancy

Sara L. White*, Dharmintra Pasupathy, Naveed Sattar, Scott M. Nelson, Debbie A. Lawlor, Annette L. Briley, Paul T. Seed, Paul Welsh, Lucilla Poston, On behalf of the UPBEAT Consortium

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

32 Citations (Scopus)
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Abstract

Aims/hypothesisAntenatal obesity and associated gestational diabetes (GDM) are increasing worldwide. While pre-existing insulin resistance is implicated in GDM in obese women, the responsible metabolic pathways remain poorly described. Our aim was to compare metabolic profiles in blood of obese pregnant women with and without GDM 10 weeks prior to and at the time of diagnosis by OGTT.
MethodsWe investigated 646 women, of whom 198 developed GDM, in this prospective cohort study, a secondary analysis of UK Pregnancies Better Eating and Activity Trial (UPBEAT), a multicentre randomised controlled trial of a complex lifestyle intervention in obese pregnant women. Multivariate regression analyses adjusted for multiple testing, and accounting for appropriate confounders including study intervention, were performed to compare obese women with GDM with obese non-GDM women. We measured 163 analytes in serum, plasma or whole blood, including 147 from a targeted NMR metabolome, at time point 1 (mean gestational age 17 weeks 0 days) and time point 2 (mean gestational age 27 weeks 5 days, at time of OGTT) and compared them between groups.
ResultsMultiple significant differences were observed in women who developed GDM compared with women without GDM (false discovery rate corrected p values <0.05). Most were evident prior to diagnosis. Women with GDM demonstrated raised lipids and lipoprotein constituents in VLDL subclasses, greater triacylglycerol enrichment across lipoprotein particles, higher branched-chain and aromatic amino acids and different fatty acid, ketone body, adipokine, liver and inflammatory marker profiles compared with those without GDM.
Conclusions/interpretationAmong obese pregnant women, differences in metabolic profile, including exaggerated dyslipidaemia, are evident at least 10 weeks prior to a diagnosis of GDM in the late second trimester.
Original languageEnglish
Pages (from-to)1903-1912
Number of pages10
JournalDiabetologia
Volume60
Issue number10
Early online date1 Aug 2017
DOIs
Publication statusPublished - Oct 2017

Keywords

  • Biomarkers
  • Gestational diabetes
  • Lipids
  • Obesity
  • Pregnancy
  • Targeted metabolome

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