Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 106, Issue 11, Pages E4372-E4388Publisher
ENDOCRINE SOC
DOI: 10.1210/clinem/dgab475
Keywords
diabetes; gestational; hypertension; gestational; metabolomics; nuclear magnetic resonance; biomolecular; pre-eclampsia; pregnancy; pregnant women
Categories
Funding
- EVO research funding
- Academy of Finland
- Signe and Ane Gyllenberg Foundation
- Sigrid Juselius Foundation
- University of Helsinki Re-search Funds
- Finnish Medical Foundation
- Juho Vainio Foundation
- Novo Nordisk Foundation
- Jane and Aatos Erkko Foundation
- Paivikki and Sakari Sohlberg Foundation
- Alfred Kordelin Foundation
- Ahokas Foundation
- Finnish Foundation for Cardiovascular Disease
- Helsinki University Hospital (HUH)
- Samfundet Folkhalsan
- Finska Lakaresallskapet
- Viipuri Tuberculosis Foundation
- The Finnish Diabetes Research Foundation
- British Heart Foundation [RE/18/5/34216]
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The study reveals that pregnant women with obesity and pregnancy disorders have similar metabolic impacts, indicating a shared metabolic origin. Furthermore, women with obesity show smaller metabolic changes during pregnancy.
Context: Comprehensive assessment of metabolism in maternal obesity and pregnancy disorders can provide information about the shared maternal-fetal milieu and give insight into both maternal long-term health and intergenerational transmission of disease burden. Objective: To assess levels, profiles, and change in the levels of metabolic measures during pregnancies complicated by obesity, gestational diabetes (GDM), or hypertensive disorders. Design, Setting and Participants: A secondary analysis of 2 study cohorts, PREDO and RADIEL, including 741 pregnant women. Main Outcome Measures: We assessed 225 metabolic measures by nuclear magnetic resonance in blood samples collected at median 13 [interquartile range (IQR) 12.4-13.7], 20 (IQR 19.3-23.0), and 28 (27.0-35.0) weeks of gestation. Results: Across all 3 time points women with obesity [body mass index (BMI) >= 30 kg/m(2)] in comparison to normal weight (BMI 18.5-24.99 kg/m(2)) had significantly higher levels of most very-low-density lipoprotein-related measures, many fatty and most amino acids, and more adverse metabolic profiles. The change in the levels of most metabolic measures during pregnancy was smaller in obese than in normal weight women. GDM, preeclampsia, and chronic hypertension were associated with metabolic alterations similar to obesity. The associations of obesity held after adjustment for GDM and hypertensive disorders, but many of the associations with GDM and hypertensive disorders were rendered nonsignificant after adjustment for BMI and the other pregnancy disorders. Conclusions: This study shows that the pregnancy-related metabolic change is smaller in women with obesity, who display metabolic perturbations already in early pregnancy. Metabolic alterations of obesity and pregnancy disorders resembled each other suggesting a shared metabolic origin.
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