Early metabolic biomarkers in neonates of diabetic mothers: predictive insights from amino acid and acylcarnitine profiling

To investigate early metabolic biomarkers in neonates born to mothers with gestational diabetes mellitus (GDM), focusing on amino acid and acylcarnitine profiles to assess metabolic risk, including obesity and future metabolic syndrome. This retrospective study analyzed dried blood spot samples from 184 GDM and 167 control neonates. GDM was categorized as large-for-gestational-age (LGA) or appropriate-for-gestational-age (AGA). Amino acid and acylcarnitine concentrations at 24–48 h postnatal age were measured using liquid chromatography–tandem mass spectrometry (LC–MS/MS). Neonatal hypoglycemia was defined and managed according to standard guidelines. Principal component analysis (PCA) was performed to identify clustering patterns. Tyrosine concentrations were significantly lower in the GDM-LGA group compared to the control-AGA group (p = 0.018). Total carnitine levels were higher in GDM-LGA infants relative to controls (p The study identifies distinctive early metabolic profiles in neonates of gestational diabetic mothers, including lower tyrosine and altered acylcarnitine patterns, which may signal a predisposition to metabolic disorders. These findings support early metabolic screening protocols and targeted follow-up for high-risk infants. Longitudinal studies are warranted to confirm the predictive value of these biomarkers and to clarify the long-term impacts of metabolic disturbances in GDMs.为探究妊娠糖尿病（gestational diabetes mellitus, GDM）母亲所产新生儿的早期代谢生物标志物，本研究聚焦氨基酸与酰基肉碱谱，以评估包括肥胖及未来代谢综合征在内的代谢风险。本回顾性研究分析了184例GDM新生儿与167例对照新生儿的干血斑样本。将GDM新生儿划分为大于胎龄儿（large-for-gestational-age, LGA）组与适于胎龄儿（appropriate-for-gestational-age, AGA）组。于新生儿出生后24~48小时采集样本，采用液相色谱-串联质谱法（liquid chromatography–tandem mass spectrometry, LC-MS/MS）检测其氨基酸与酰基肉碱浓度。依照标准指南对新生儿低血糖症进行定义与临床管理。通过主成分分析（principal component analysis, PCA）识别样本的聚类模式。结果显示，GDM-LGA组的酪氨酸浓度显著低于对照-AGA组（p=0.018）；GDM-LGA婴儿的总肉碱水平高于对照组（p<0.05）。本研究发现妊娠糖尿病母亲所产新生儿存在独特的早期代谢特征谱，包括酪氨酸水平降低与酰基肉碱模式改变，这或提示其存在代谢紊乱的易感倾向。上述研究结果可为高风险婴儿的早期代谢筛查方案与针对性随访提供支持。未来需开展纵向研究，以验证这些生物标志物的预测价值，并阐明妊娠糖尿病母亲所产新生儿代谢紊乱的长期影响。