Nontargeted metabolomics reveals the potential mechanism underlying the association between birthweight and metabolic disturbances.

AIMS: The aim of this study was to characterize the metabolites associated with small- and large-gestational-age newborns in maternal and cord blood, and to investigate potential mechanisms underlying the association between birthweight and metabolic disturbances. RESEARCH DESIGN AND METHODS: We recorded detailed anthropometric data of mother-offspring dyads. Untargeted metabolomic assays were performed on 67 pairs of cord blood and maternal fasting plasma samples including 16 pairs of small-for-gestational (SGA, < 10th percentile) dyads, 28 pairs of appropriate-for-gestational (AGA, approximate 50 percentile) dyads, and 23 pairs of large-for-gestational (LGA, > 90th percentile) dyads. The association of metabolites with newborn birthweight was conducted to screen for metabolites with U-shaped and line-shaped distributions. The association of metabolites with maternal and fetal phenotypes was also performed. RESULTS: We found 2 types of metabolites that changed in different patterns according to newborn birthweight. One type of metabolite exhibited a "U-shaped" trend of abundance fluctuation in the SGA-AGA-LGA groups. The results demonstrated that cuminaldehyde level was lower in the SGA and LGA groups, and its abundance in cord blood was negatively correlated with maternal BMI (r = -0.352 p = 0.009) and weight gain (r = -0.267 p = 0.043). 2-Methoxy-estradiol-17b 3-glucuronide, which showed enrichment in the SGA and LGA groups, was positively correlated with homocysteine (r = 0.44, p < 0.001) and free fatty acid (r = 0.42, p < 0.001) in maternal blood. Serotonin and 13(S)-HODE were the second type of metabolites, denoted as "line-shaped", which both showed increasing trends in the SGA-AGA-LGA groups in both maternal and cord blood and were both significantly positively correlated with maternal BMI before pregnancy. Moreover, cuminaldehyde, serotonin, 13(S)-HODE and some lipid metabolites showed a strong correlation between maternal and cord blood. CONCLUSIONS: These investigations demonstrate broad-scale metabolomic differences associated with newborn birthweight in both pregnant women and their newborns. The U-shaped metabolites associated with both the SGA and LGA groups might explain the U-shaped association between birthweight and metabolic dysregulation. The line-shaped metabolites might participate in intrauterine growth regulation. These observations might help to provide new insights into the insulin resistance and the risk of metabolic disturbance of SGA and LGA babies in adulthood and might identify potential new markers for adverse newborn outcomes in pregnant women.

The relationship between changes in vitamin A, vitamin E, and oxidative stress levels, and pregnancy outcomes in patients with gestational diabetes mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. This study aims to analyze the relationship between the changes in vitamin A, vitamin E, and oxidative stress levels, and pregnancy outcomes in GDM patients. METHODS: A total of 104 GDM patients admitted to our hospital between January 2018 and January 2019 were selected as the study group, and 126 pregnant women who received healthy examinations in the same hospital during the same period were selected as the control group. Vitamin A, E, and oxidative stress [total antioxidant capacity (TAOC), malondialdehyde (MDA), red blood cell glutathione (GSH), and superoxide dismutase (SOD)] between the two groups were compared. Age, pre-pregnancy body mass index (BMI), pre-pregnancy waist-to-hip ratio (waist/hip circumference), parity, gravidity, glycosylated hemoglobin, and other related index levels were collected for the GDM patients. Multivariate logistic regression analysis was used to analyze the risk factors affecting the pregnancy outcomes of the GDM patients. RESULTS: The levels of vitamin A, SOD, GSH, and TAOC in the study group were significantly lower than those in the control group, and the levels of vitamin E and MDA were significantly higher than those in the control group (P<0.05). Of the 104 GDM patients, 43 had adverse pregnancy outcomes, and 61 had no adverse pregnancy outcomes. There was a significant difference between the adverse and non-adverse pregnancy outcome groups in the levels of glycosylated hemoglobin, vitamin A, vitamin E, MDA, SOD, GSH, and TAOC (P<0.05). Analysis of the unconditional multivariate logistic regression model showed that the expression levels of glycosylated hemoglobin, vitamin A, vitamin E, MDA, SOD, GSH, and TAOC were independent risk factors affecting the pregnancy outcomes of GDM patients (P<0.05). CONCLUSIONS: Vitamin A, E, and oxidative stress levels are abnormally expressed in GDM, and are independent risk factors affecting the pregnancy outcomes in GDM patients. Therefore, the clinical monitoring of oxidative stress levels and vitamin supplementation should be increased, as these may be of great significance in improving pregnancy outcomes in GDM patients.

Analysis of the efficacy of resveratrol treatment in patients with scarred uterus.

Scarred uterus is caused by cesarean section surgery, and this condition affects further gestation and delivery in patients. Previous evidence suggested that resveratrol, a polyphenol compound, presents beneficial outcomes for patients with scarred uterus. Therefore, the aim of the present study was to analyze the efficacy of resveratrol in the treatment of patients with scarred uterus. The efficacy of resveratrol in the formation of new vessels and re-epithelialization of the endometrium was analyzed. The present results demonstrated that resveratrol treatment reduced uterus scarring in the majority of patients (87.36%) compared with the control. It was also observed that the plasma levels of ß-human chorionic gonadotropin were downregulated by resveratrol treatment in patients with scarred uterus. Furthermore, resveratrol treatment promoted the remodeling of the scarred uterus, the regeneration of the endometrium and improved pregnancy outcomes. In conclusion, the findings of the current study indicate that resveratrol treatment may be a potential strategy for the treatment of scarred uterus patients, which contributes to the improvement of pregnancy outcomes.