First trimester metabolomics 1H-NMR study of the urinary profile predicts gestational diabetes mellitus development in obese women

Abstract

Objective

Obesity is one of the main risk factors for the development gestational diabetes mellitus (GDM). Thus, we aim to identify changes in the urinary metabolomics profile of obese women at first trimester of pregnancy in order to predict later GDM diagnosis.

Research design and methods

In this nested case-control study, urine samples collected in the first trimester of pregnancy obtained from obese women who developed GDM (n = 29) and obese women who did not develop diabetes (n = 25 NO GDM) were analyzed with Nuclear Magnetic Resonance spectroscopy combined with Multivariate Statistical Analysis. GDM diagnosis was obtained with one-step oral glucose load.

Results

OPLS-DA significantly separated the GDM women from NO GDM women. Specifically, GDM women were characterized by a higher level of tryptophan, trigonelline, hippurate, and threonine, and lower levels of 1-methylnicotinamide, 3-hydroxykynurenine, glycocholate, isoleucine, kynurenine, and valine compared to NO GDM women.

Conclusion

In a prevalently Caucasian population, the changes of some metabolites such as tryptophan, trigonelline, and branch-chained amino acids in the urinary profile of obese women in the first trimester are able to make unequivocal prediction of those which later test positive for GDM. This approach could be useful to diagnose much earlier obese women with GDM allowing lifestyle counselling and other interventions.

Keywords:

• Metabolomics
• gestational diabetes
• urine
• obesity
• personalized medicine

Acknowledgement

No funding was available for this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Conceptualization: V.F. and F.F.; sample collection: E.P. and F.M.; formal analysis: C.P. and I.N.; investigation: C.P., I.N., A.N., R.P.; data curation: C.P., I.N., A.N., R.P.; writing—original draft preparation: C.P., R.P. A.D. and F.F.; writing—review and editing: C.P., R.P., F.F., V.F., L.A.; supervision, V.F., F.F. and L.A. All authors have read and agreed to the published version of the manuscript.