Effect of maternal body mass index on the steroid profile in women with gestational diabetes mellitus

Abstract

ObjectiveTo explore the effect of maternal body mass index (BMI) on steroid hormone profiles in women with gestational diabetes mellitus (GDM) and those with normal glucose tolerance (NGT).MethodsWe enrolled 79 women with NGT and 80 women with GDM who had a gestational age of 24–28 weeks. The participants were grouped according to their BMI. We quantified 11 steroid hormones profiles by liquid chromatography-tandem mass spectrometry and calculated the product-to-precursor ratios in the steroidogenic pathway.ResultsWomen with GDM and BMI<25kg/m2 showed higher concentrations of dehydroepiandrosterone (DHEA) (p<0.001), testosterone (T) (p=0.020), estrone (E1) (p=0.010) and estradiol (E2) (p=0.040) and lower Matsuda index and HOMA-β than women with NGT and BMI<25kg/m2. In women with GDM, concentrations of E1 (p=0.006) and E2 (p=0.009) declined, accompanied by reduced E2/T (p=0.008) and E1/androstenedione (A4) (p=0.010) in the BMI>25 kg/m2 group, when compared to that in the BMI<25 kg/m2 group. The values of E2/T and E1/A4 were used to evaluate the cytochrome P450 aromatase enzyme activity in the steroidogenic pathway. Both aromatase activities negatively correlated with the maternal BMI and positively correlated with the Matsuda index in women with GDM.ConclusionsNGT women and GDM women with normal weight presented with different steroid hormone profiles. Steroidogenic pathway profiling of sex hormones synthesis showed a significant increase in the production of DHEA, T, E1, and E2 in GDM women with normal weight. Additionally, the alteration of steroid hormone metabolism was related to maternal BMI in women with GDM, and GDM women with overweight showed reduced estrogen production and decreased insulin sensitivity compared with GDM women with normal weight.

Using metabolomics and proteomics to identify the potential urine biomarkers for prediction and diagnosis of gestational diabetes

“…89 , 90 Steroid hormones regulate pancreatic function and induce IR, mainly including diabetogenic progesterone, antidiabetic estradiol, androgens related to IR and hyperinsulinemia, neuroactive steroids that affect pituitary functioning, and cortisol, which inhibits the proinflammatory effects of corticotropin-releasing hormone (CRH). 91 , 92 In the study of López-Hernández, seven steroid derivatives were significantly elevated in GDM patient urine. The dysregulation of the metabolic pathway in steroid hormone biosynthesis that was identified in the pathway topology analysis and pathway enrichment analysis had a close relationship with development of GDM.…”