The Study Of Milk Metabolomics In Women With Gestational Diabetes And Its Effect On The Growth And Development Of The Offspring In Early Birth

Objective Gestational diabetes mellitus(GDM)is a pathophysiological state caused by glucose tolerance.GDM can increase the adverse outcome of the offspring.The nutrition of the offspring was derived from the milk of the mother in early birth,and the milk was an important nutrient in the early birth of the offspring,and determining the development and growth of offspring in early birth.In this study,the metabolics of milk coming from maternal of GDM were be explored.The aim of this study was to explore the relativity of maternal milk and neonatal outcome in women with gestational diabetes mellitus(GDM)and without gestational diabetes mellitus and investigate the effect of maternal milk metabolomics on GDM neonatal development and growth.Thus,this study will provide a theoretical basis for preventing the occurrence of complications in GDM adult.Methods Colostrum,transition milk,and mature milk from normal pregnancies(n = 94)and GDM complicated pregnancies(n = 90)were subjected to metabolomic profiling by the gas chromatography mass spectrometry(GC-MS).The T test and repeated ANOVA were used to identify discriminating metabolites.Pathway analyses were performed using a Pathway Activity Profiling R package based on the KEGG online database.TO explore the correlation of GDM breastfeeding and childgrowth and development in women with gestational diabetes mellitus and without gestational diabetes mellitus,case control method and comparison average compared in two groups of children was used,and there was no statistically significant difference between the average of two groups.Results After normal pregnancies,there were changes in the levels of59 metabolites from colostrum,to transition milk and to mature milk;these metabolites included 23 amino acids and their derivatives,8 organic acids,4 TCA cycle derivatives,2 cofactors and vitamines,13 unsaturated fatty acids,7 saturated fatty acids and 1 glycolytic intermediate.Similarly,there were changes in 58 metabolites in colostrum,transition milk and mature milk from GDM pregnancies,including 18 amino acids and derivatives,8organic acids,3 TCA cycle derivatives,2 cofactors and vitamines,14 unsaturated fatty acids,10 saturated fatty acids and 1 glycolytic intermediate.21 metabolites were found at significantly different levels after normal as compared to GDM pregnancies,including 3 amino acids,2fatty acids,and 5 organic acids,2 TCA cycle intermediates,and 1vitamin.The weight,head circumference and body length of the three different periods after birth of GDM and normal pregnant women were measured,and the development indicators were compared between offspring of women with gestational diabetes mellitus(GDM)and without gestational diabetes mellitus in three periods.Comparison results showed that: * birth weight categories,F = 0.361,P = 0.549 ? 0.05;Head circumference 1 * group,F = 0.152,P = 0.697 ? 0.05;Length 1 * group,F= 0.058,P = 0.810 ? 0.05;* 10 days postpartum weight categories,F =1.321,P = 0.252 ? 0.05;Head circumference 2 * group,F=0.001,P=0.9800.05;Length 2 * group,F = 0.552,P = 0.458 ? 0.05;Postpartum 42 days *weight categories,F = 0.013,P = 0.911 ? 0.05;Head circumference 3 *group,F = 0.049,P = 0.825 ? 0.05;Length 3 * group,F = 1.651,0.200,P= 0.200 ? according to alpha = 0.05 level.There were no significant correlation between offspring's development and growth and milk in women with gestational diabetes mellitus and without gestational diabetes mellitus.Conclusions The metabolic profile of human milk is dynamic throughout the first month of lactation;high levels of amino acids in colostrum and high levels of saturated fatty acids and unsaturated fatty acids in mature milk were features of both normal and GDM pregnancies,and may be critical for neonatal development in the first month of life.Changes in the milk metabolome were similar in GDM and normal pregnancies,although differences in glutamine and fatty acids in colostrum were identified.Through the study of different developmental stages of GDM offspring,we concluded that the development and growth of offspring breastfed exclusively were independent with GDM at the early stage of birth.Although there were a certain difference between milk in women with gestational diabetes mellitus and without gestational diabetes mellitus,these differences were not enough to lead to the adverse outcome of the offspring in the short term.The long-term effects on the development and growth of offspring need follow-up study.