Perspectives from metabolomics in the early diagnosis and prognosis of gestational diabetes mellitus

Abstract

Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders in pregnant women. The early detection of GDM provides an opportunity for the effective treatment of hyperglycemia in pregnancy, thus decreasing the risk of adverse perinatal outcomes for mothers and newborns. Metabolomics, an emerging technique, offers a novel point of view in understanding the onset and development of diseases and has been repeatedly used in various gestational periods in recent studies of GDM. Moreover, metabolomics provides varied opportunities in the different diagnoses of GDM from prediabetes or predisposition to diabetes, the diagnosis of GDM at a gestational age several weeks earlier than that used in the traditional method, and the assessment of prognosis considering the physiologic subtypes of GDM and clinical indexes. Longitudinal metabolomics truly facilitates the dynamic monitoring of metabolic alterations over the course of pregnancy. Herein, we review recent advancements in metabolomics and summarize evidence from studies on the application of metabolomics in GDM, highlighting the aspects of the diagnosis and differential diagnoses of GDM in an early stage. We also discuss future study directions concerning the physiologic subtypes, prognosis, and limitations of metabolomics.

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

“… 37 The complex data produced by high-throughput metabolomics require advanced algorithms to process, including traditional approaches such as univariate analysis and logistic regression, as well as novel approaches such as machine learning. 39 Changes in metabolic composition directly reflect disease processes, environmental exposures, and toxicological and nutritional intakes at a certain time since metabolites act as substrates or products in metabolic pathways. After validation, these key metabolites can be applied for disease diagnosis, treatment evaluation, and even prediction of disease susceptibility.…”

Utilizing Amniotic Fluid Metabolomics to Monitor Fetal Well-Being: A Narrative Review of the Literature

“…In recent years, "omics" technologies have become popular and changed the scientific approach due to their role in describing diseases and biological systems through the mostly non-invasive analysis of large volumes of data [ 1 , 2 ]. Among these tools, metabolomics, offering new analytical techniques, explores and detects the set of low molecular weight molecules, including biological molecules, sugars, lipids, small peptides, vitamins, and amino acids, present in cells, tissues, organs, and biological fluids, mapping their phenotype into metabolic profiles [ 1 , 3 ]. The main advantages are high diagnostic power, high speed, convenience, and relatively low cost [ 1 , 4 ].…”

Exploring preconception signatures of metabolites in mothers with gestational diabetes mellitus using a non-targeted approach

“…Emerging evidence rooted in epidemiological studies has also investigated plasma, serum, and even urine metabolite profiles during pregnancy that significantly differed between women with and without GDM [8,[10][11][12][13][14][15]. However, the findings in metabolite panels were inconsistent, and later assessment in pregnancy was subjective to reverse causality [9,16]. In addition, metabolic disruption as early as the preconception phase could help in understanding the etiology of GDM, which has been lacking in current literature.…”