Study of Metabolic Profile in Infants of Diabetic Mothers
Basma Ismail Abdel Fattah Mohamed;
Abstract
For women with diabetes mellitus, pregnancy can present some particular challenges for both mother and child. If the woman has diabetes as an inter-current disease in pregnancy, it can cause different illnesses of their child.
Metabolomics in maternal-fetal medicine is still an “embryonic” science. However, there is already an increasing interest in metabolome of normal and complicated pregnancies, and neonatal outcomes. Tissues used for metabolomics interrogations of pregnant women, fetuses and newborns are amniotic fluid, blood, plasma, cord blood, placenta, urine, and vaginal secretions.
The metabolomic approach consists of two sequential phases. The analytical phase is designed to profile all low molecular weight metabolites in a given biological specimen to generate an all-inclusive spectrum. Possible sources of biological tissues that can be exploited in pregnancy are both from the mother (plasma, urine, vaginal fluids, milk), the fetus (amniotic fluid, umbilical cord blood), and the newborn (plasma, urine, placenta, saliva, other fluids). Different technologies might be generally adopted such as tandam mass spectrometry. The phase of data analysis and interpretation requires highly complex data mining software and an ample database of metabolites to describe the nodes and networking of metabolic pathways.
In view of these data this study aimed to detect metabolic profile in infants of gestational and pre- gestational diabetic mothers using cord blood and to correlate them to the infant outcome. Also to study the relation between their metabolic profile and maternal diabetes and birth weight, neonatal anthroprometric measures.
This case control study was carried out on 50 infants of diabetic mothers and 20 controls. Infants of gestational diabetic mother under diet control were excluded.
All infants included were subjected to detailed medical history, clinical examinations, and laboratory investigation “extended metabolic screening” by tandem mass spectrometry using amino acids and acyl carnitine by MS/MS.
The results showed that maternal age and BMI were higher among diabetic mother compared to controls and HbA1c among diabetic was indicate poor glycemic control.
Cord blood glucose was significantly lower among neonated of diabetic while ponderal index was significantly higher among them compared to controls. Length and occipto- frontal circumference were significantly lower among neonate of diabetic mothers compared to controls.
The results also showed that gestational age was lower among neonates of diabetic mothers and caesarian section delivery was more common among them.
The study revealed significant higher white’s classification (B and C) and maternal HbA1C among pre- gestational diabetic mothers compared to gestational diabetic mothers.
the metabolic profiles recorded in this study among amino acids, fatty acids and organic acids revealed that 17 variables were highly important to differentiate between cases and controls and these variables were C14:1,C18:1, Histidine, C2-Carntine, C5-Carnitine, C14-Carnitine,C12-Carnitine, C10-Carnitine,Glutamic acid, Phe: Tyr, C18-Carnitine, C10-1, C8:1, Cit: Phe, C4-Carnitine, Leu: Ala and Gly: Ala, the most important variable “feature of interest” was C14: 1.
Cit: Phe is the only variable of significant difference between GDM and PGDM being higher in PGDM.
The feature of interest (C14:1) was potentially correlated with C3, Histidine, C12- carnitine and potentially uncorrelated with valine, Lue: Phe, Methionine.
From these variables, different components obtained through certain meatbo-analyst software program. The percent of variability of data represented by each component can differentiate between cases and controls and the best component obtained is component number (4).
In comparison between cases and controls C14:1, Cit:Phe, Histidine and C5DC were of low values in all cases and the other features were of high values.
Metabolomics in maternal-fetal medicine is still an “embryonic” science. However, there is already an increasing interest in metabolome of normal and complicated pregnancies, and neonatal outcomes. Tissues used for metabolomics interrogations of pregnant women, fetuses and newborns are amniotic fluid, blood, plasma, cord blood, placenta, urine, and vaginal secretions.
The metabolomic approach consists of two sequential phases. The analytical phase is designed to profile all low molecular weight metabolites in a given biological specimen to generate an all-inclusive spectrum. Possible sources of biological tissues that can be exploited in pregnancy are both from the mother (plasma, urine, vaginal fluids, milk), the fetus (amniotic fluid, umbilical cord blood), and the newborn (plasma, urine, placenta, saliva, other fluids). Different technologies might be generally adopted such as tandam mass spectrometry. The phase of data analysis and interpretation requires highly complex data mining software and an ample database of metabolites to describe the nodes and networking of metabolic pathways.
In view of these data this study aimed to detect metabolic profile in infants of gestational and pre- gestational diabetic mothers using cord blood and to correlate them to the infant outcome. Also to study the relation between their metabolic profile and maternal diabetes and birth weight, neonatal anthroprometric measures.
This case control study was carried out on 50 infants of diabetic mothers and 20 controls. Infants of gestational diabetic mother under diet control were excluded.
All infants included were subjected to detailed medical history, clinical examinations, and laboratory investigation “extended metabolic screening” by tandem mass spectrometry using amino acids and acyl carnitine by MS/MS.
The results showed that maternal age and BMI were higher among diabetic mother compared to controls and HbA1c among diabetic was indicate poor glycemic control.
Cord blood glucose was significantly lower among neonated of diabetic while ponderal index was significantly higher among them compared to controls. Length and occipto- frontal circumference were significantly lower among neonate of diabetic mothers compared to controls.
The results also showed that gestational age was lower among neonates of diabetic mothers and caesarian section delivery was more common among them.
The study revealed significant higher white’s classification (B and C) and maternal HbA1C among pre- gestational diabetic mothers compared to gestational diabetic mothers.
the metabolic profiles recorded in this study among amino acids, fatty acids and organic acids revealed that 17 variables were highly important to differentiate between cases and controls and these variables were C14:1,C18:1, Histidine, C2-Carntine, C5-Carnitine, C14-Carnitine,C12-Carnitine, C10-Carnitine,Glutamic acid, Phe: Tyr, C18-Carnitine, C10-1, C8:1, Cit: Phe, C4-Carnitine, Leu: Ala and Gly: Ala, the most important variable “feature of interest” was C14: 1.
Cit: Phe is the only variable of significant difference between GDM and PGDM being higher in PGDM.
The feature of interest (C14:1) was potentially correlated with C3, Histidine, C12- carnitine and potentially uncorrelated with valine, Lue: Phe, Methionine.
From these variables, different components obtained through certain meatbo-analyst software program. The percent of variability of data represented by each component can differentiate between cases and controls and the best component obtained is component number (4).
In comparison between cases and controls C14:1, Cit:Phe, Histidine and C5DC were of low values in all cases and the other features were of high values.
Other data
| Title | Study of Metabolic Profile in Infants of Diabetic Mothers | Other Titles | تقييم ملف التمثيل الغذائى لدى مواليد الأمهات المصابة بمرض البول السكرى | Authors | Basma Ismail Abdel Fattah Mohamed | Issue Date | 2014 |
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