title: The prediction of type 2 diabetes in women with previous gestational diabetes mellitus using lipidomics.
abstract: OBJECTIVE
  The risk of developing diabetes is greater for women with previous gestational diabetes mellitus (GDM). In the general population, plasma lipidomic analysis can identify individuals at risk of developing type 2 diabetes. The aim of this study was to determine whether circulating lipid levels 12 weeks following a GDM pregnancy were associated with an increased risk of developing type 2 diabetes.
  
  
  METHODS
  Plasma lipid profiles containing >300 lipids were measured in 104 normal glucose-tolerant women 12 weeks following an index GDM pregnancy using electrospray-ionisation tandem mass spectrometry. Women were assessed for 10 years for development of overt type 2 diabetes.
  
  
  RESULTS
  Among the 104 women with previous GDM, 21 (20%) developed diabetes during the median follow-up period of 8.5 years. Three lipid species, the cholesteryl ester species CE 20:4, the alkenylphosphatidylethanolamine species PE(P-36:2) and the phosphatidylserine species PS 38:4, were independently and positively associated with the development of type 2 diabetes. In a clinical model of prediction of type 2 diabetes that included age, BMI, and levels of pregnancy fasting glucose, postnatal fasting glucose, triacylglycerol and total cholesterol, the addition of these three lipid species resulted in an improvement in the net reclassification index of 22.3%.
  
  
  CONCLUSIONS
  The lipid species CE 20:4, PE(P-36:2) and PS 38:4 were significant risk factors for the development of type 2 diabetes in women with a previous history of GDM. This report is the first to use plasma lipidomic analysis to identify individual lipids as potential biomarkers for the prediction of type 2 diabetes in women with a history of GDM.
authors.affiliation: Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Level 4/163 Studley Road, Heidelberg, 3084, VIC, Australia, mlappas@unimelb.edu.au.
authors.forename: Martha
authors.initials: M
authors.lastname: Lappas
authors.forename: Piyushkumar A
authors.initials: PA
authors.lastname: Mundra
authors.forename: Gerard
authors.initials: G
authors.lastname: Wong
authors.forename: Kevin
authors.initials: K
authors.lastname: Huynh
authors.forename: Debra
authors.initials: D
authors.lastname: Jinks
authors.forename: Harry M
authors.initials: HM
authors.lastname: Georgiou
authors.forename: Michael
authors.initials: M
authors.lastname: Permezel
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Meikle
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D002788:Cholesterol Esters / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D008055:Lipids / Q000097:blood*; D010714:Phosphatidylethanolamines / Q000097:blood; D010718:Phosphatidylserines / Q000097:blood; D011247:Pregnancy; D018570:Risk Assessment; D053719:Tandem Mass Spectrometry; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002788:Cholesterol Esters; D008055:Lipids; D010714:Phosphatidylethanolamines; D010718:Phosphatidylserines; D014280:Triglycerides; D002784:Cholesterol