Insights into maternal metabolism
Overweight and obesity are often accompanied with adverse alterations in host metabolism. These alterations increase the risk for metabolic complications including gestational diabetes in pregnant women. Moreover, metabolic profile may be related to extent of obesity in pregnant women: obese and overweight women differ according to the serum lipid and amino acid content at early pregnancy (Houttu et al. 2018). Obese pregnant women may have higher risk for short and long term health risks than overweight women, since they have shown to have higher concentrations of several lipids and branched chain amino acids compared to overweight women at early pregnancy. Our metabolomics studies also reveal alterations in maternal metabolism between women with gestational diabetes and healthy women. We demonstrate (Mokkala et al. 2020b) that women with gestational diabetes have higher concentration of several lipid variables, branched chain fatty acids and marker of low grade inflammation, all of these also known to increase the risk for cardiovascular diseases. These differences were observed already at early pregnancy, suggesting that women who develop GDM at later pregnancy, have poorer metabolic outcomes, which increases the risk for cardiovascular disease.
Our study utilizing metabolomics analysis shows that a clearly distinct metabolic profile is observed in women with gestational diabetes when compared to their healthy counterparts. Interestingly, this profile deviated even more if the patient was receiving medical treatment (i.e. metformin and/or insulin) when compared to those treated with diet only (Mokkala et al. 2020c). The aberrant metabolic profile apparently manifest already at early pregnancy, i.e. prior to the diagnosis of gestational diabetes and may thus represent a novel way to allow early identification of the women in increased risk for gestational diabetes (Mokkala et al. 2020b) .
We have also investigated the relationship between two markers for low grade inflammation high sensitive C-reactive protein, hsCRP and Glycoprotien acetylation, GlycA, and metabolomics profile at early pregnancy. In this study, we show that GlycA, which is a novel marker, was more sensitive in reflecting several metabolomics markers and thus may be considered as better inflammatory marker in reflecting metabolic status (Mokkala et al. 2020d).