Unsaturated plasma phospholipids are consistently lower in the patients diagnosed with gestational diabetes mellitus throughout pregnancy: A longitudinal metabolomics study of Chinese pregnant women part 1.

BACKGROUND: Gestational diabetes mellitus (GDM) is a milder degree of hyperglycaemia diagnosed during pregnancy that can lead to serious, long-term consequences for both mother and foetus. The pathophysiology of GDM is not fully understood. The number of pregnant women diagnosed with GDM has been steadily increasing, but effective screening tools for early risk stratification are still missing. The emerging field of metabolomics has the potential to provide new insights and as a result is increasingly being used in studies of GDM. However, no study to date has investigated the longitudinal changes associated with GDM as pregnancy progresses. We investigated maternal plasma of a longitudinal cohort of normal pregnancies and pregnancies complicated by GDM. METHODS: Based on ultra-performance hydrophilic interaction liquid chromatography/hybrid quadrupole time-of-flight mass spectrometry, an untargeted metabolomics study was performed to explore the changes in the plasma metabolome of GDM cases and healthy controls. Innovative sample preparation and multilevel statistical methods were employed to enhance our ability to analyse the longitudinal plasma samples by LC-MS. RESULTS: A number of polyunsaturated or chemically modified phospholipids were significantly lower in the plasma of pregnant women that developed GDM when compared to healthy controls, while no difference was observed for the saturated phospholipids. The reduction of these lipid species in the participants that developed GDM could be detected as early in the first trimester and the changes were independent of the stage of gestation and the steroid hormones in the plasma. CONCLUSIONS: These differences observed in our study were detected well before the onset of GDM, and might provide further insights into the etiology or pathophysiology of GDM.