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An Unbiased Lipidomics Approach Identifies Early Second Trimester Lipids Predictive of Maternal Glycemic Traits and Gestational Diabetes Mellitus.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Lu, Liangjian 
Jenkins, Benjamin 

Abstract

OBJECTIVE: To investigate the relationship between early second trimester serum lipidomic variation and maternal glycemic traits at 28 weeks and to identify predictive lipid biomarkers for gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: Prospective study of 817 pregnant women (discovery cohort, n = 200; validation cohort, n = 617) who provided an early second trimester serum sample and underwent an oral glucose tolerance test (OGTT) at 28 weeks. In the discovery cohort, lipids were measured using direct infusion mass spectrometry and correlated with OGTT results. Variable importance in projection (VIP) scores were used to identify candidate lipid biomarkers. Candidate biomarkers were measured in the validation cohort using liquid chromatography-mass spectrometry and tested for associations with OGTT results and GDM status. RESULTS: Early second trimester lipidomic variation was associated with 1-h postload glucose levels but not with fasting plasma glucose levels. Of the 13 lipid species identified by VIP scores, 10 had nominally significant associations with postload glucose levels. In the validation cohort, 5 of these 10 lipids had significant associations with postload glucose levels that were independent of maternal age and BMI, i.e., TG(51.1), TG(48:1), PC(32:1), PCae(40:3), and PCae(40:4). All except the last were also associated with maternal GDM status. Together, these four lipid biomarkers had moderate ability to predict GDM (area under curve [AUC] = 0.71 ± 0.04, P = 4.85 × 10-7) and improved the prediction of GDM by age and BMI alone from AUC 0.69 to AUC 0.74. CONCLUSIONS: Specific early second trimester lipid biomarkers can predict maternal GDM status independent of maternal age and BMI, potentially enhancing risk factor-based screening.

Description

Keywords

Adult, Area Under Curve, Blood Glucose, Diabetes, Gestational, Female, Glucose Tolerance Test, Humans, Lipid Metabolism, Lipids, Maternal Age, Metabolomics, Pregnancy, Pregnancy Trimester, Second, Prospective Studies, Risk Factors

Journal Title

Diabetes Care

Conference Name

Journal ISSN

0149-5992
1935-5548

Volume Title

Publisher

American Diabetes Association
Sponsorship
Wellbeing of Women (RG1644)
National Institute for Health Research (NIHR) (unknown)
National Institute for Health Research (NIHR) (via West Anglia Comprehensive Local Research Network (CLRN)) (UKCRN 11822)
National Institute for Health Research (NIHR) via Comprehensive Local Research Network (CLRN) (UKCRN 15224)
National Institute for Health Research (NIHR) (via West Anglia Comprehensive Local Research Network (CLRN)) (11822)
Medical Research Council (MC_UU_12015/2)
Medical Research Council (G0600717)
Biotechnology and Biological Sciences Research Council (BB/M027252/2)
Diabetes UK (11/0004241)
Biotechnology and Biological Sciences Research Council (BB/M027252/1)
Medical Research Council (MC_U106179472)
Medical Research Council (G0600717/1)
This part of the Cambridge Baby Growth Study was funded by grants from the Wellbeing of Women (RG1644) and Diabetes UK (11/0004241). The lipidomics assays were supported by the Medical Research Council (UD99999906) and Cambridge Lipidomics Biomarker Research Initiative (G0800783). Core funding was also obtained through the Medical Research Council, European Union Framework 5 World Cancer Research Fund, Mothercare Foundation and the Newlife Foundation for Disabled Children. There has also been support from National Institute for Health Research Cambridge Biomedical Research Centre.