Metabolomic profiling in the prediction of Gestational Diabetes Mellitus

描述(申请人提供)：妊娠期糖尿病(GDM)在美国约占7%的妊娠并发症。然而，肥胖和糖尿病的流行，以及修订的GDM诊断标准，正在极大地增加GDM的患病率，根据一些估计，高达18%的妊娠。值得注意的是，这一不断增加的患病率是因为伴随而来的不良后遗症风险，不仅在围产期，如剖腹产率和新生儿出生损伤的增加，而且在怀孕后，包括母亲和子女患2型糖尿病(T2 DM)的风险增加。及早发现妊娠期糖尿病风险增加的妇女将为制定有针对性的妊娠期糖尿病和T2 DM风险预防战略提供机会。我们的建议利用了我们在新兴技术方面的专业知识，以及我们现有的研究人群，以进一步确定患GDM和T2 DM风险更高的女性的特征。我们的具体目标1将检查一组在妊娠期跟踪观察的妊娠期糖尿病患者。我们的具体目标2-4将检查糖尿病预防计划(DPP)中有妊娠期糖尿病病史的女性患T2 DM的队列，同时检查研究干预和种族对结果的影响。

DESCRIPTION (provided by applicant): Gestational diabetes mellitus (GDM) complicates approximately 7% of pregnancies in the U.S. However, the epidemics of obesity and diabetes, as well as revised GDM diagnostic criteria, are dramatically increasing the prevalence of GDM, as high as 18% of pregnancies according to some estimates. This increasing prevalence is noteworthy because of the concomitant risk for adverse sequelae, not only in the peripartum period, such as increased rates of caesarean section delivery and neonatal birth injury, but also subsequent to pregnancy, including increased risk for type 2 diabetes mellitus (T2DM) for both mother and offspring. Early identification of women at increased risk for GDM would provide the opportunity for the development of targeted GDM and T2DM risk prevention strategies. Our proposal capitalizes on our expertise in emerging technologies, as well as our existing study populations, to further characterize women at increased risk for developing GDM and T2DM. Our Specific Aim 1 will examine a cohort of women followed during pregnancy for the development of GDM. Our Specific Aims 2-4 will examine the cohort of women within the Diabetes Prevention Program (DPP) with a history of GDM for the development of T2DM while examining the effects of study intervention and race on the outcome.