在不同妊娠阶段妊娠期糖尿病孕妇的血清代谢组学的分析

Serum metabolomics analysis of pregnant women with gestational diabetes mellitus in different gestational stages

目的对不同妊娠阶段的妊娠期糖尿病(GDM)孕妇进行血清代谢组学分析,以探索GDM不同妊娠阶段的病理机制及代谢特点。方法随机选取2015年10月至2016年12月在广州中医药大学第一附属医院产科规范产检的60例GDM孕妇作为研究对象,按孕周分为中孕组(24~28周,A组)29例和晚孕组(28~32周,B组)31例。用超高效液相色谱-飞行时间质谱(UPLC/Q-TOFMS)代谢组学技术对所有患者血清进行代谢组学检测,采集谱图数据,用PCA、PLS-DA、OPLS-DA等模式识别方法进行分析,探究差异性血清代谢标志物。结果与A组相比较,B组中有11种代谢物质呈现上升趋势,其中有8种代谢物(m/z分别为703.5739,782.5688,806.5686,758.5691,544.3442,834.5984,828.5507,730.5892)差异有统计学意义(P<0.05),提示GDM不同妊娠阶段的孕妇血清代谢物谱发生了变化。对其中的4种m/z分别为782.5688,758.5691,730.5892,544.3442的代谢物进行二级质谱定性,经查阅数据库信息,发现差异性代谢物分别为磷脂酰胆碱[PC(36∶4)、(34∶2)]、磷脂酰乙醇胺[PE(20∶1)]、溶血磷脂酰胆碱[LPC(22:4)]。结论GDM患者在不同妊娠阶段中血清代谢物谱存在一定的差异,可能是鉴别GDM在不同妊娠阶段的潜在标志物,且其代谢差异主要表现磷脂代谢途径上。

Objective To detect the serum metabolic markers in pregnant women with gestational diabetes mellitus(GDM)in different gestational stages,in order to explore the pathological and metabolic characteristics of GDM.Methods From October 2015 to December2016,60 GDM pregnant women were randomly enrolled in this study.They were regularly join antenatal care in our hospital.According to their gestational time,29 pregnant women(24-28 weeks)and 31 pregnant women(28-32 weeks)were divided into group A and group B,respectively.Using UPLC/Q-TOF-MS metabonomics technology to conduct metabolomic detection for all specimens.In addition,collected spectral data and adopted PCA,PLS-DA,OPLS-DA to explore the difference of serum metabolic markers.Results Group B had 11 kinds of rising metabolic materials compared with group A.There were 8 kinds of metabolites(m/z are 703.5739,782.5688,806.5686,758.5691,544.3442,834.5984,544.3442,834.5984)showed statisticaldifferences(P<0.05),suggesting that the serum metabolite profiles of GDM were changed in different gestational stages.Among these metabolites,4 metabolites with m/z of 782.5688,758.5691,730.5892 and 544.3442 were characterized by secondary mass spectrometry.By consulting the database information,those different metabolites were phosphatidyl choline[PC(36∶4),(34∶2)],phosphatidyl ethanolamine[PE(20:1)],and lysophosphatidyl choline[LPC(22:4)],respectively.Conclusion There are certain differences in serum metabolite profiles of GDM patients in different gestational stages.PC[(36:4),(34:2)],PE(20:1),LPC(22:4)could be potential markers for identifying GDM in different gestational stages,and the metabolic difference is mainly manifested in the phospholipid metabolic pathway.