The effects of gestational diabetes mellitus with advanced maternal age on the metabolite profiles of serum and urine

Abstract Background: Gestational diabetes mellitus (GDM) is characterized by impaired glucose tolerance in pregnancy and without a history of diabetes mellitus. It can lead to adverse maternal and neonatal outcomes. The incidence of GDM is closely related to maternal age, but there are only a few pregnancy-related metabolomic studies involving advanced maternal age (AMA) in China.Methods: 20 GDM and 20 normal pregnant participants(≥35 years old) were recruited from the Complex Lipids in Mothers and Babies (CLIMB) study. Maternal plasma and urine metabolomes collected at the first and third trimester were analyzed using gas chromatography-mass spectrometry (GC-MS). Results: Of the metabolites identified using GC–MS, 165 metabolites and 192 metabolites were found in plasma and urine respectively. However, urine metabolomic profiles were unable to distinguish GDM from controls, while there were 14 and 39 significantly different metabolites in plasma of the two groups in first and third trimester. Especially, by combining seven metabolites including cysteine, malonic acid, stearic acid, alanine, 11,14-eicosadienoic acid, 2-methyloctadecanoic acid, and arachidic acid using multivariant receiver operating characteristic(ROC) models, we were capable of discriminating GDM from healthy pregnancies with an area under curve (AUC) of 0.928 at early gestation.Conclusion: This study explores metabolomic profiles between GDM and normal pregnancies longitudinally. Several metabolites have the potential to be biomarkers to predict GDM with AMA. Besides, the discordant metabolome profiles between the two groups could be helpful to understand the etiology of elderly GDM.