Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33615
Title: Metabolomic insights into maternal and neonatal complications in pregnancies affected by type 1 diabetes.
Austin Authors: Meek, Claire L;Stewart, Zoe A;Feig, Denice S;Furse, Samuel;Neoh, Sandra L ;Koulman, Albert;Murphy, Helen R
Affiliation: Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Mount Sinai Hospital, Sinai Health System, New York, NY, USA.
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.;Core Metabolomics and Lipidomics Laboratory, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
Endocrinology
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.;Core Metabolomics and Lipidomics Laboratory, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
Norwich Medical School, University of East Anglia, Norwich, UK.
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Department of Medicine, University of Toronto, Toronto, ON, Canada.
Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada.
Issue Date: Nov-2023
Date: 2023
Publication information: Diabetologia 2023-11; 66(11)
Abstract: Type 1 diabetes in pregnancy is associated with suboptimal pregnancy outcomes, attributed to maternal hyperglycaemia and offspring hyperinsulinism (quantifiable by cord blood C-peptide). We assessed metabolomic patterns associated with risk factors (maternal hyperglycaemia, diet, BMI, weight gain) and perinatal complications (pre-eclampsia, large for gestational age [LGA], neonatal hypoglycaemia, hyperinsulinism) in the Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial (CONCEPTT). A total of 174 CONCEPTT participants gave ≥1 non-fasting serum sample for the biorepository at 12 gestational weeks (147 women), 24 weeks (167 women) and 34 weeks (160 women) with cord blood from 93 infants. Results from untargeted metabolite analysis (ultrahigh performance LC-MS) are presented as adjusted logistic/linear regression of maternal and cord blood metabolites, risk factors and perinatal complications using a modified Bonferroni limit of significance for dependent variables. Maternal continuous glucose monitoring time-above-range (but not BMI or excessive gestational weight gain) was associated with increased triacylglycerols in maternal blood and increased carnitines in cord blood. LGA, adiposity, neonatal hypoglycaemia and offspring hyperinsulinism showed distinct metabolite profiles. LGA was associated with increased carnitines, steroid hormones and lipid metabolites, predominantly in the third trimester. However, neonatal hypoglycaemia and offspring hyperinsulinism were both associated with metabolite changes from the first trimester, featuring triacylglycerols or dietary phenols. Pre-eclampsia was associated with increased abundance of phosphatidylethanolamines, a membrane phospholipid, at 24 weeks. Altered lipid metabolism is a key pathophysiological feature of type 1 diabetes pregnancy. New strategies for optimising maternal diet and insulin dosing from the first trimester are needed to improve pregnancy outcomes in type 1 diabetes.
URI: https://ahro.austin.org.au/austinjspui/handle/1/33615
DOI: 10.1007/s00125-023-05989-2
ORCID: 0000-0002-4176-8329
0000-0003-4267-2051
0000-0001-9387-7079
0000-0001-9998-051X
0000-0002-5489-0614
Journal: Diabetologia
PubMed URL: 37615689
ISSN: 1432-0428
Type: Journal Article
Subjects: Cord blood
LGA
Lipidomics
Metabolomics
Neonatal hypoglycaemia
Pre-eclampsia
Prediction
Pregnancy
Pregnancy complications
Pregnancy in people with diabetes
Pregnancy outcome
Type 1 diabetes
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