Early pregnancy urinary biomarkers of fatty acid and carbohydrate metabolism in pregnancies complicated by gestational diabetes.
OBJECTIVE
Alterations in organic acid biomarkers from fatty acid and carbohydrate metabolism have been documented in type 2 diabetes patients. However, their association with gestational diabetes mellitus (GDM) is largely unknown.


METHODS
Participants were 25 GDM cases and 25 non-GDM controls. Biomarkers of fatty acid (adipate, suberate and ethylmalonate) and carbohydrate (pyruvate, l-lactate and β-hydroxybutyrate) metabolism were measured in maternal urine samples collected in early pregnancy (17 weeks) using liquid chromatography-mass spectrometry methods. Logistic regression were used to calculate odds ratios (OR) and 95% confidence intervals (CI).


RESULTS
GDM cases and controls differed in median urinary concentrations of ethylmalonate (3.0 vs. 2.3μg/mg creatinine), pyruvate (7.4 vs. 2.1μg/mg creatinine), and adipate (4.6 vs. 7.3μg/mg creatinine) (all p-values <0.05). Women in the highest tertile for ethylmalonate or pyruvate concentrations had 11.4-fold (95%CI 1.10-117.48) and 3.27-fold (95%CI 0.72-14.79) increased risk of GDM compared with women in the lowest tertile for ethylmalonate and pyruvate concentrations, respectively. Women in the highest tertile for adipate concentrations, compared with women in the lowest tertile, had an 86% reduction in GDM risk (95%CI 0.02-0.97).


CONCLUSIONS
These preliminary findings underscore the importance of altered fatty acid and carbohydrate metabolism in the pathogenesis of GDM.
Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA. Electronic address: Chun-fang.Qiu@Swedish.org.
Chunfang
C
Qiu
Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
Daniel A
DA
Enquobahrie
Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA.
Ihunnaya O
IO
Frederick
Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA.
Tanya K
TK
Sorensen
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
Miguel Angel Luque
MA
Fernandez
Genova Diagnostics, Duluth, GA, USA.
Robert M
RM
David
Genova Diagnostics, Duluth, GA, USA.
J Alexander
JA
Bralley
Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
Michelle A
MA
Williams
D020155:3-Hydroxybutyric Acid / Q000652:urine*; D000328:Adult; D015415:Biomarkers / Q000652:urine*; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005227:Fatty Acids / Q000652:urine*; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000652:urine*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000209:etiology / Q000652:urine; D011446:Prospective Studies; D011773:Pyruvates / Q000652:urine*; D012307:Risk Factors
D015415:Biomarkers; D005227:Fatty Acids; D011773:Pyruvates; D019344:Lactic Acid; D020155:3-Hydroxybutyric Acid
Adipate; Carbohydrate metabolism; Ethylmalonate; Fatty acid metabolism; Gestational diabetes mellitus; Organic acid profile