1H NMR studies of alterations in lipoprotein profiles in women diagnosed with gestational diabetes mellitus (GDM) and after delivery.

The lipid abnormalities are observed in pregnant women with normal glucose tolerance (NGT) and those diagnosed with gestational diabetes mellitus (GDM), but in the latter, they are intensified and may indicate underlying metabolic dysfunction that transiently manifests during pregnancy. Due to the complex relationship between lipid metabolism and glucose regulation, alterations in lipoproteins may act as preliminary biomarkers for the early detection and monitoring of GDM and postpartum changes. In the current study, we performed a 1H NMR analysis of plasma lipoproteins in the cohort comprising pregnant NGT women and those diagnosed with GDM at three critical time points: 24-28 gestation week and 3 and 12 months postpartum. After assignment of lipoprotein-associated signals in NMR spectra, Partial Least Squares Discriminant Analysis (PLS-DA) revealed clear distinctions between NGT and GDM groups. Correlation analysis revealed a moderate negative correlation of CH3VLDL, a moderate positive correlations of CH2CH2C=C with 2 h-OGTT and 1 h-OGTT, and a significant negative correlation of CH3VLDL, and a positive correlation of CH2CH2C=C were noted for HOMA IR. At the 3-months mark, the concentrations of (CH2)n LDL, CH2CH2CH2CO VLDL, all unsaturated lipids, and (CH=CH) LDL + VLDL, CH2/CH3 LDL + VLDL, and CH=CH/CH3 LDL + VLDL were decreased, while the concentrations of (C18 VLDL, CH3 LDL, CH2CH2C=C, CH2C=C, CH2CO, C=CCH2C=C, choline N(CH3)3, glyceryl CH2OCOR) were increased. The concentrations of selected fractions at the 1-year postpartum time point remained unchanged. Our findings provide essential insights into lipoprotein dysregulation in GDM and underscore possible implications for early intervention and long-term metabolic risk reduction for maternal health.