Metabolomic Biomarkers in Gestational Diabetes Mellitus: A Review of the Evidence

Abstract

Gestational diabetes mellitus (GDM) is the fastest growing type of diabetes, affecting between 2 to 38% of pregnancies worldwide, varying considerably depending on diagnostic criteria used and sample population studied. Adverse obstetric outcomes include an increased risk of macrosomia, and higher rates of stillbirth, instrumental delivery, and birth trauma. Metabolomics, which is a platform used to analyse and characterise a large number of metabolites, is increasingly used to explore the pathophysiology of cardiometabolic conditions such as GDM. This review aims to summarise metabolomics studies in GDM (from inception to January 2021) in order to highlight prospective biomarkers for diagnosis, and to better understand the dysfunctional metabolic pathways underlying the condition. We found that the most commonly deranged pathways in GDM include amino acids (glutathione, alanine, valine, and serine), carbohydrates (2-hydroxybutyrate and 1,5-anhydroglucitol), and lipids (phosphatidylcholines and lysophosphatidylcholines). We also highlight the possibility of using certain metabolites as predictive markers for developing GDM, with the use of highly stratified modelling techniques. Limitations for metabolomic research are evaluated, and future directions for the field are suggested to aid in the integration of these findings into clinical practice.

Plasma Short-Chain Fatty Acids and Their Derivatives in Women with Gestational Diabetes Mellitus

“…In this study, the association of selected SCFA and their derivatives with GDM of different phenotypes was investigated. There are many risk factors for the development of GDM, with advanced maternal age being one of them [1]. In our cohort, women with GDM were older than both groups of controls (Table S3).…”

“…Currently, in the diagnosis of GDM, treatment strategies to prevent the occurrence of the disease are being introduced. It has been found that, when medical therapy for achieving good glycemic control is initiated, blood glucose is reduced, but not other parameters such as the already known key parameters of GDM, lipids, cholesterol or amino acids [1,42]. In our study, glucose showed a gradual downward trend in three groups of women with GDM; on the contrary, cholesterol, triglycerides, LDL cholesterol and non-HDL cholesterol were increased across groups of women with GDM (Figure 2).…”

“…Worldwide, gestational diabetes mellitus (GDM) affects 2-38% of pregnant women [1]. It is associated with significant short-and long-term adverse health outcomes for mothers and children.…”

Immunobiology of Gestational Diabetes Mellitus in Post-Medawar Era

“…Gestational diabetes can sometimes be controlled by diet and exercise (10,11). As a consequence of a new international detection method of diabetes as recommended by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG), the incidence of GDM may be diagnosed in much higher numbers (15-18%) than currently diagnosed (5-8%) (12). Since the IADPSG method identifies increased numbers of patients with the GDM features, it has been debated whether this method is cost-effective, as compared to the current methods of diagnosis.…”

Gas Chromatography–Mass Spectroscopy-Based Metabolomics Analysis Reveals Potential Biochemical Markers for Diagnosis of Gestational Diabetes Mellitus

“…Gestational diabetes mellitus (GDM), the most common form of metabolic complication in pregnancy (Tenenbaum-Gavish et al, 2020), is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy (Sweeting et al, 2019). GDM affects from 2 to 38% of pregnancies, depending on the diagnostic criteria and population studied (Alesi et al, 2021). Additionally, its prevalence worldwide is rising (Mdoe et al, 2021).…”