Background. Gestational diabetes mellitus (GDM) is a type of glucose intolerance disorder that first occurs during women’s pregnancy. The main diagnostic method for GDM is based on the midpregnancy oral glucose tolerance test. The rise of metabolomics has expanded the opportunity to better identify early diagnostic biomarkers and explore possible pathogenesis. Methods. We collected blood serum from 34 GDM patients and 34 normal controls for a LC-MS-based metabolomics study. Results. 184 metabolites were increased and 86 metabolites were decreased in the positive ion mode, and 65 metabolites were increased and 71 were decreased in the negative ion mode. Also, it was found that the unsaturated fatty acid metabolism was disordered in GDM. Ten metabolites with the most significant differences were selected for follow-up studies. Since the diagnostic specificity and sensitivity of a single differential metabolite are not definitive, we combined these metabolites to prepare a ROC curve. We found a set of metabolite combination with the highest sensitivity and specificity, which included eicosapentaenoic acid, docosahexaenoic acid, docosapentaenoic acid, arachidonic acid, citric acid, α-ketoglutaric acid, and genistein. The area under the curves (AUC) value of those metabolites was 0.984 between the GDM and control group. Conclusions. Our results provide a direction for the mechanism of GDM research and demonstrate the feasibility of developing a diagnostic test that can distinguish between GDM and normal controls clearly. Our findings were helpful to develop novel biomarkers for precision or personalized diagnosis for GDM. In addition, we provide a critical insight into the pathological and biological mechanisms for GDM.

中文翻译：

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基于 LC-MS 的代谢分析鉴定妊娠期糖尿病的独特生物标志物特征

背景。妊娠糖尿病（GDM）是一种葡萄糖不耐症，首先发生在女性怀孕期间。GDM 的主要诊断方法是基于妊娠中期口服葡萄糖耐量试验。代谢组学的兴起扩大了更好地识别早期诊断生物标志物和探索可能发病机制的机会。方法。我们收集了 34 名 GDM 患者和 34 名正常对照者的血清，用于基于 LC-MS 的代谢组学研究。结果。正离子模式下，有184种代谢物增加，86种代谢物减少，负离子模式下，65种代谢物增加，71种代谢物减少。此外，还发现GDM中不饱和脂肪酸代谢紊乱。选择差异最显着的十种代谢物进行后续研究。由于单一差异代谢物的诊断特异性和敏感性不确定，因此我们将这些代谢物组合起来绘制 ROC 曲线。我们发现了一组灵敏度和特异性最高的代谢物组合，其中包括二十碳五烯酸、二十二碳六烯酸、二十二碳五烯酸、花生四烯酸、柠檬酸、α-酮戊二酸和染料木黄酮。GDM 组和对照组之间这些代谢物的曲线下面积 (AUC) 值为 0.984。结论。我们的研究结果为 GDM 的机制研究提供了方向，并证明了开发能够清楚区分 GDM 和正常对照的诊断测试的可行性。我们的研究结果有助于开发新的生物标志物，用于 GDM 的精确或个性化诊断。此外，我们还对 GDM 的病理和生物学机制提供了重要的见解。