martes, 29 de abril de 2014

Metabolic fingerprint of Gestational Diabetes Mellitus

Metabolic fingerprint of Gestational Diabetes Mellitus



Metabolic fingerprint of Gestational Diabetes Mellitus

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Highlights

First multiplatform non-targeted metabolomic analysis of human gestational diabetes
Plasma fingerprints reveal disease-specific metabolic imbalances in diabetic pregnant women.
Lysoglycerophospholipids reflect glucose intolerance in gestational diabetes.

Abstract

Gestational Diabetes (GDM) is causing severe short- and long-term complications for mother, fetus or neonate. As yet, the metabolic alterations that are specific for the development of GDM have not been fully determined, which also precludes the early diagnosis and prognosis of this pathology. In this pilot study, we determine the metabolic fingerprint, using a multiplatform LC–QTOF/MS, GC–Q/MS and CE–TOF/MS system, of plasma and urine samples of 20 women with GDM and 20 with normal glucose tolerance in the second trimester of pregnancy. Plasma fingerprints allowed for the discrimination of GDM pregnant women from controls. In particular, lysoglycerophospholipids showed a close association with the glycemic state of the women. In addition, we identified some metabolites with a strong discriminative power, such as LPE(20:1), (20:2), (22:4); LPC(18:2), (20:4), (20:5); LPI(18:2), (20:4); LPS(20:0) and LPA(18:2), as well as taurine-bile acids and long-chain polyunsaturated fatty acid derivatives. Finally, we provide evidence for the implication of these compounds in metabolic routes, indicative of low-grade inflammation and altered redox-balance, that may be related with the specific pathophysiological context of the genesis of GDM. This highlights their potential use as prognostic markers for the identification of women at risk to develop severe glucose intolerance during pregnancy.

Biological significance

Gestational Diabetes Mellitus (GDM) is increasing worldwide and, although diabetes usually remits after pregnancy, women with GDM have a high risk of developing postpartum type 2-diabetes, particularly when accompanied by obesity. Therefore, understanding the pathophysiology of GDM, as well as the identification of potentially modifiable risk factors and early diagnostic markers for GDM are relevant issues. In the present study, we devised a multiplatform metabolic fingerprinting approach to obtain a comprehensive picture of the early metabolic alternations that occur in GDM, and may reflect on the specific pathophysiological context of the disease. Future studies at later stages of gestation will allow us to validate the discriminant power of the identified metabolites.

Graphical abstract


Full-size image (9 K)

Keywords

  • Gestational Diabetes Mellitus
  • Maternal metabolism
  • Metabolic fingerprinting

Corresponding author contact information
Corresponding author at: Facultad de Farmacia, Universidad CEU San Pablo Ctra. Boadilla del Monte km 5,3, 28668 Madrid, Spain. Tel.: + 34 91 3724760.

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