Unique Metabolic Profiles Associate with Gestational Diabetes and Ethnicity in Low and High-Risk Women Living in the UK

Abstract

AbstractBackgroundGestational Diabetes Mellitus (GDM) is the most common global pregnancy complication; however, prevalence varies substantially between ethnicities with South Asians (SA) experiencing up to 3-times the risk of the disease compared to white Europeans (WEs). Factors driving this discrepancy are unclear, although the metabolome is of great interest as GDM is known to be characterised by metabolic dysregulation.ObjectiveThis primary aim was to characterise and compare the metabolic profiles of GDM in SA and WE women (at < 28 weeks’ gestation) from the Born in Bradford (BIB) prospective birth cohort in the UK.Methods146 fasting serum metabolites, from 2668 pregnant WE and 2671 pregnant South Asian (SA) women (average BMI 26.2 kg/m2, average age 27.3 years) were analysed using partial least squares discriminatory analyses to characterise GDM status. Linear associations between metabolite values and post-oral glucose tolerance test measures of dysglycemia (fasting glucose and 2-hour post glucose) were also examined.ResultsSeven metabolites associated with GDM status in both ethnicities (variable importance in projection (VIP) ≥1), while 6 additional metabolites associated with GDM only in WE women. Unique metabolic profiles were observed in healthy weight women who later developed GDM, with distinct metabolite patterns identified by ethnicity and BMI status. Of the metabolite values analysed in relation to dysglycemia, lactate, histidine, apolipoprotein A1, HDL cholesterol, HDL2 cholesterol associated with decreased glucose concentration, while DHA and the diameter of very low-density lipoprotein particles (nm) associated with increased glucose concertation in WE women; while in SAs albumin alone associated with decreased glucose concentration.ConclusionsThis study shows that the metabolic risk profile for GDM differs between WE and SA women enrolled in BiB the UK. This suggests that aetiology of the disease differs between ethnic groups and that ethnic-appropriate prevention strategies may be beneficial.