Gestional Diabets Mellitus Metabolomics Based On~1H NMR Spectroscopy

Metabonomics is termed as the qualitative and quantiantive measurement of the dynamic multi-parametric metabolic response of a living system to pathophysiological stimuli or genetic modification. Gestational diabetes mellitus (GDM) is a separate type of metabolic disease, only during pregnancy. The traditional diagnostic methods of GDM exist misdiagnosis and other shortcomings. In this paper, The NMR-based metabonomics is applied to GDM studies. By systematically analyzing the difference of the small molecular metabolites in serum and urine, induced by GDM, the related biomarkers and metabolic pathways could be derived, and our result could provide a scientific basis for the early diagnosis and treatment of GDM. The main contents of this study are as follows:Firstly, the application of metabonomics in GDM was summarized in detail, and the advantages of metabonomics in GDM study were listed.Further, high resolution1H NMR spectroscopy in combination with multivariate statistical analysis, was applied to investigate metabolic profilings of serum and urine from GDM patients. Results showed that the serum from GDM patients were highlighted by the increased level of glucose, TMAO, succinate and glycine, while elevated glycine, dimethylglycine, homogentisate, N-methylnicotinamide (NMND) and declined malonate, ethanolamine, phenylacetylglutamine(PAG) and hippurate were identified in urine. These metabolites were analyzed detailedly based on metabolite pathway database. Studies showed that carbohydrates, lipids and amino acid metabolism are disturbed by GDM, and the enterohepatic circulation system and other metabolic disorders are also affected. Particularly in the later period of GDM, with the enhancement effect of insulin resistance and the increasing physiological needs of mother and fetus, energy metabolism is enhanced quickly in pregnant women, and the body’s metabolic balance was disturbed. In addition, as liver and kidney are important material transformation and excretion organs, the rapid metabolite changes of pregnant women may exacerbate the burden of liver and kidney, even result in the lesions of liver and kidney. Results have shown that the NMR-based metabonomics approach provides a robust technical platform to study the pathomechanism on GDM, and will have broad application prospects in early diagnosis and individual therapy of GDM in the future.