NMR based clinical metabolomics can predict Gestational diabetes mellitus (GDM) during first trimester in North Indian Population: a pilot study

Gestational diabetes mellitus (GDM), defined as hyperglycemia first identified during pregnancy in the second or third trimester, is a growing global concern due to the rising prevalence of obesity and diabetes. GDM is associated with significant short- and long-term health complications for both women and their offspring. During pregnancy, it increases the risks of obstetric issues such as gestational hypertension, dystocia, postpartum hemorrhage, and preterm birth, alongside fetal complications like macrosomia and congenital malformations. Additionally, GDM has intergenerational consequences, predisposing women and their children to chronic conditions including type 2 diabetes, obesity, cardiovascular disease, and dyslipidemia later in life. South Asian women have the highest global prevalence of GDM, hypothesized to result from genetic predispositions, higher adiposity, and dietary differences. However, this population remains underrepresented in GDM research, with only seven metabolomic studies to date, most involving fewer than 20 cases. This study seeks to identify serum metabolites associated with GDM and elucidate metabolic pathways distinguishing GDM from non-GDM pregnancies in North Indian women.妊娠糖尿病（Gestational diabetes mellitus, GDM）指妊娠中晚期首次确诊的高血糖状态，由于肥胖与糖尿病患病率持续攀升，其已成为日益严峻的全球公共卫生问题。GDM会对孕产妇及其子代带来显著的短期与远期健康并发症风险：妊娠期间，该疾病会增加孕产妇罹患妊娠高血压、难产、产后出血及早产等产科并发症的风险，同时也可引发胎儿巨大儿、先天性畸形等不良妊娠结局。此外，GDM还存在代际健康影响，会使孕产妇及其子代在晚年罹患2型糖尿病、肥胖、心血管疾病及血脂异常等慢性疾病的风险显著升高。 南亚女性是全球GDM患病率最高的人群，现有假说认为这与遗传易感性、体脂水平偏高及饮食结构差异相关。但该群体在GDM相关研究中的占比极低，截至目前仅开展过7项代谢组学研究，且多数研究的病例数不足20例。本研究旨在明确北印度女性血清中与GDM相关的代谢物，并阐明区分GDM妊娠与非GDM妊娠的代谢通路。