A Predictive Metabolic Signature for the Transition From Gestational Diabetes Mellitus to Type 2 Diabetes.
A Predictive Metabolic Signature for the Transition From Gestational Diabetes Mellitus to Type 2 Diabetes.
复制标题
DOI：
10.2337/db15-1720
复制
发表时间：
2016-09
期刊：
影响因子：
7.7
通讯作者：
Wheeler MB
中科院分区：
文献类型：
--
作者：
Allalou A;Nalla A;Prentice KJ;Liu Y;Zhang M;Dai FF;Ning X;Osborne LR;Cox BJ;Gunderson EP;Wheeler MB
妊娠期糖尿病 (GDM) 影响 3-14% 的妊娠，其中 20-50% 的女性在 5 年内进展为 2 型糖尿病 (T2D)。本研究试图开发代谢组学特征来预测从 GDM 到 T2D 的转变。产后 6-9 周（基线）纳入了 1,035 名 GDM 妊娠女性的前瞻性队列，并在 2 年内每年进行 T2D 筛查。在 1,010 名基线时未患 T2D 的女性中，有 113 名在 2 年内进展为 T2D。另外 17 名女性在 2 至 4 年间患上了 T2D。巢式病例对照设计使用了 122 名事件病例患者，这些患者按年龄、孕前 BMI 和种族/民族与非病例患者进行匹配。我们利用基线空腹血浆进行代谢组学，并鉴定出 21 种代谢物，这些代谢物因发生的 T2D 状态而显着不同。机器学习优化产生的决策树模型可以预测 T2D 发病率，在训练集中的判别力为 83.0%，在独立测试集中的判别力为 76.9%，这远远优于单独测量空腹血糖水平。美国糖尿病协会建议在 GDM 后的产后早期通过口服葡萄糖耐量测试进行 T2D 筛查，这是一个耗时且不方便的过程。我们的代谢组学特征通过单个空腹血液样本预测了 T2D 发病率。这项研究代表了第一个在独立测试组中验证的从 GDM 到 T2D 转变的代谢组学研究，有助于早期干预。
Gestational diabetes mellitus (GDM) affects 3–14% of pregnancies, with 20–50% of these women progressing to type 2 diabetes (T2D) within 5 years. This study sought to develop a metabolomics signature to predict the transition from GDM to T2D. A prospective cohort of 1,035 women with GDM pregnancy were enrolled at 6–9 weeks postpartum (baseline) and were screened for T2D annually for 2 years. Of 1,010 women without T2D at baseline, 113 progressed to T2D within 2 years. T2D developed in another 17 women between 2 and 4 years. A nested case-control design used 122 incident case patients matched to non–case patients by age, prepregnancy BMI, and race/ethnicity. We conducted metabolomics with baseline fasting plasma and identified 21 metabolites that significantly differed by incident T2D status. Machine learning optimization resulted in a decision tree modeling that predicted T2D incidence with a discriminative power of 83.0% in the training set and 76.9% in an independent testing set, which is far superior to measuring fasting plasma glucose levels alone. The American Diabetes Association recommends T2D screening in the early postpartum period via oral glucose tolerance testing after GDM, which is a time-consuming and inconvenient procedure. Our metabolomics signature predicted T2D incidence from a single fasting blood sample. This study represents the first metabolomics study of the transition from GDM to T2D validated in an independent testing set, facilitating early interventions.
登录
查看更多内容
影响因子：
7.7
作者：
Floegel A;Stefan N;Yu Z;Mühlenbruch K;Drogan D;Joost HG;Fritsche A;Häring HU;Hrabě de Angelis M;Peters A;Roden M;Prehn C;Wang-Sattler R;Illig T;Schulze MB;Adamski J;Boeing H;Pischon T
通讯作者：
Pischon T
影响因子：
6.9
作者：
Mihalik, Stephanie J.;Goodpaster, Bret H.;Kelley, David E.;Chace, Donald H.;Vockley, Jerry;Toledo, Frederico G. S.;DeLany, James P.
通讯作者：
DeLany, James P.
影响因子：
3.5
作者：
Bennett, Wendy L.;Ennen, Christopher S.;Clark, Jeanne M.
通讯作者：
Clark, Jeanne M.
影响因子：
7.2
作者：
Blatt, Amy J.;Nakamoto, Jon M.;Kaufman, Harvey W.
通讯作者：
Kaufman, Harvey W.
影响因子：
16.2
作者：
Kim, Catherine;McEwen, Laura N.;Walker, Elizabeth A.
通讯作者：
Walker, Elizabeth A.