PT  - JOURNAL ARTICLE
AU  - Claudia Sikorski
AU  - Sandi Azab
AU  - Russell J de Souza
AU  - Meera Shanmuganathan
AU  - Dipika Desai
AU  - Koon Teo
AU  - Stephanie A Atkinson
AU  - Katherine Morrison
AU  - Milan Gupta
AU  - Philip Britz-McKibbin
AU  - Sonia S Anand
TI  - Serum metabolomic signatures of gestational diabetes in South Asian and white European women
AID  - 10.1136/bmjdrc-2021-002733
DP  - 2022 Apr 01
TA  - BMJ Open Diabetes Research & Care
PG  - e002733
VI  - 10
IP  - 2
4099  - http://drc.bmj.com/content/10/2/e002733.short
4100  - http://drc.bmj.com/content/10/2/e002733.full
SO  - BMJ Open Diab Res Care2022 Apr 01; 10
AB  - Introduction This study aimed to identify serum metabolomic signatures associated with gestational diabetes mellitus (GDM), and to examine if ethnic-specific differences exist between South Asian and white European women.Research design and methods Prospective cohort study with a nested case–control analysis of 600 pregnant women from two Canadian birth cohorts; using an untargeted approach, 63 fasting serum metabolites were measured and analyzed using multisegment injection-capillary electrophoresis-mass spectrometry. Multivariate logistic regression modeling was conducted overall and by cohort.Results The proportion of women with GDM was higher in South Asians (27.1%) compared with white Europeans (17.9%). Several amino acid, carbohydrate, and lipid pathways related to GDM were common to South Asian and white European women. Elevated circulating concentrations of glutamic acid, propionylcarnitine, tryptophan, arginine, 2-hydroxybutyric acid, 3-hydroxybutyric acid, and 3-methyl-2-oxovaleric acid were associated with higher odds of GDM, while higher glutamine, ornithine, oxoproline, cystine, glycine with lower odds of GDM. Per SD increase in glucose concentration, the odds of GDM increased (OR=2.07, 95% CI 1.58 to 2.71), similarly for metabolite ratios: glucose to glutamine (OR=2.15, 95% CI 1.65 to 2.80), glucose to creatinine (OR=1.79, 95% CI 1.39 to 2.32), and glutamic acid to glutamine (OR=1.46, 95% CI 1.16 to 1.83). South Asians had higher circulating ratios of glucose to glutamine, glucose to creatinine, arginine to ornithine, and citrulline to ornithine, compared with white Europeans.Conclusions We identified a panel of serum metabolites implicated in GDM pathophysiology, consistent in South Asian and white European women. The metabolic alterations leading to larger ratios of glucose to glutamine, glucose to creatinine, arginine to ornithine, and citrulline to ornithine in South Asians likely reflect the greater burden of GDM among South Asians compared with white Europeans.Data are available upon reasonable request.