Is there any difference between metabolomic profiles of mothers who progress to gestational diabetes versus healthy women during pregnancy?

Background: Gestational diabetes (GD) is associated with a variety of numerous metabolic changes. Discovering related biomarkers by the metabolomic studies can provide a better understanding of the pathological processes involved in the development and progression of GD. Methods: Blood samples were taken from 400 naturally conceived healthy women aged 25-40 years old in the first trimester of pregnancy. Participants were followed up again at 28 weeks of gestation and reevaluated for GD based on American Diabetes Association (ADA) criteria. After identifying 32 women with GD as the case group, 32 healthy matched women selected as the control group. Plasma samples in the first and third trimester, were sent for nuclear magnetic resonance (NMR) testing. Altered biochemical pathways were identified in MetaboAnalyst 4.0 using Human Metabolism Database (HMDB). The comparison of altered metabolomes in two groups was assessed using multivariate logistic regression analysis in SPSS 23 software. Results: In the first trimester, the amount of increase in steroid hormones level was greater in women who progressed to GD (Impact = 0.344). In the third trimester, although we had lower levels of steroid hormones, prostaglandins and bile acids in the diabetic group vs healthy subjects, however the level of glycine conjugated bile acid was higher in affected women by GD ( Conclusions: For the first time, we reported new disrupted pathways such as steroid hormone pathways and their related altered metabolites in a group of Iranian population with GD. This may provide a better and faster way to predict, diagnose and prevent GDM in the future. Surely, further studies are required for the validation of the results.