[Screening of differential metabolites and metabolic pathways in pregnant women with gestational diabetes mellitus during the second trimester].

OBJECTIVE

To analyze serum differential metabolites and related metabolic pathways following a glucose load during the second trimester in pregnant women with gestational diabetes mellitus(GDM) using untargeted metabolomics.

METHODS

Pregnant women who registered at Nanjing Maternity and Child Health Care Hospital between April and May 2020 were selected and divided into a GDM group and a control group(CON), with 15 participants in each group, based on the result of the oral glucose tolerance test(OGTT). Serum samples were collected at 0 h and 1 h during the OGTT and analyzed using ultra-high-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS) for untargeted metabolomic profiling. Differential metabolites were identified through t-tests, principal component analysis, and orthogonal partial least squares-discriminant analysis. The identified metabolites were annotated using KEGG database, and pathway enrichment analysis was performed on the MetaboAnalyst 5.0 platform.

RESULTS

A total of 166 and 134 metabolites were identified in the positive and negative ion modes, respectively. Multivariate analysis revealed significant differences in metabolic profiles among the groups(P<0.05). In the four comparative groups-CON-0 h vs CON-1 h, GDM-0 h vs GDM-1 h, CON-0 h vs GDM-0 h, and CON-1 h vs GDM-1 h-53, 55, 17 and 31 differential metabolites were identified, respectively. Lipids and lipid-like molecules constituted the predominant category, accounting for 43.3%, 45.4%, 35.2% and 41.9% of the differential metabolites, respectively. These metabolites were significantly enriched in pathways such as arginine biosynthesis; alanine, aspartate, and glutamate metabolism; and sphingolipid metabolism(P<0.05).

CONCLUSION

Significant alterations in serum metabolic profiles were observed in women with GDM after a glucose load during the second trimester. The differential metabolites were primarily lipids and lipid-like molecules, mainly involved in amino acid metabolism and sphingolipid metabolism-related pathways.