Gestational Diabetes Mellitus (GDM) results in complications
affecting
both mothers and their offspring. Metabolomic analysis across pregnancy
provides an opportunity to better understand GDM pathophysiology.
The objective was to conduct a metabolomics analysis of first and
third trimester plasma samples to identify metabolic differences associated
with GDM development. Forty pregnant women with overweight/obesity
from a multisite clinical trial of a lifestyle intervention were included.
Participants who developed GDM (n= 20; GDM group)
were matched with those who did not develop GDM (n= 20; Non-GDM group). Plasma samples collected at the first (10–16
weeks) and third (28–35 weeks) trimesters were analyzed with
ultra-performance liquid chromatography–mass spectrometry (UPLC-MS).
Cardiometabolic risk markers, dietary recalls, and physical activity
metrics were also assessed. Four medium-chain acylcarnitines, lauroyl-,
octanoyl-, decanoyl-, and decenoylcarnitine, significantly differed
over the course of pregnancy in the GDM vs Non-GDM group in a group-by-time
interaction (p< 0.05). Hypoxanthine and inosine
monophosphate were elevated in the GDM group (p<
0.04). In both groups over time, bile acids and sorbitol increased
while numerous acylcarnitines and α-hydroxybutyrate decreased
(p< 0.05). Metabolites involved in fatty acid
oxidation and purine degradation were altered across the first and
third trimesters of GDM-affected pregnancies, providing insight into
metabolites and metabolic pathways altered with GDM development.