Lactation is associated with altered metabolomic signatures in women with gestational diabetes

D Much; A Beyerlein; A Kindt; J Krumsiek; F Stückler; M Rossbauer; A Hofelich; D Wiesenäcker; S Hivner; M Herbst; W Römisch-Margl; C Prehn; J Adamski; G Kastenmüller; F Theis; AG Ziegler; S Hummel

doi:10.1055/s-0036-1580927

Diabetologie und Stoffwechsel, Inhaltsverzeichnis

Lactation is associated with altered metabolomic signatures in women with gestational diabetes

D Much ¹^,²^,³, A Beyerlein ¹^,³, A Kindt ⁴, J Krumsiek ³^,⁴, F Stückler ⁴, M Rossbauer ¹^,², A Hofelich ¹^,³, D Wiesenäcker ¹^,²^,⁵, S Hivner ¹^,²^,³, M Herbst ¹^,²^,³, W Römisch-Margl ³^,⁶, C Prehn ⁷, J Adamski ³^,⁷^,⁸, G Kastenmüller ³^,⁶, F Theis ³^,⁴, AG Ziegler ¹^,²^,³, S Hummel ¹^,²^,³

¹Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
²Forschergruppe Diabetes e.V., Neuherberg, Germany
³German Center for Diabetes Research (DZD), München-Neuherberg, Germany
⁴Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
⁵Department of Pediatrics, Kinderklinik München Schwabing, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
⁶Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Neuherberg, Germany
⁷Genome Analysis Center, Institute of Experimental Genetics, Helmholtz Zentrum München, Neuherberg, Germany
⁸Chair for Experimental Genetics, Technical University of Munich, Freising-Weihenstephan, Germany

Abstract

Aims: Lactation for > 3 months in women with gestational diabetes is associated with a considerably reduced long-term risk for type 2 diabetes that persists for up to 15 years postpartum. However, the underlying protective mechanisms are unknown. We examined whether lactation for > 3 months is associated with altered metabolomic signatures postpartum.

Methods: We enrolled 197 women with gestational diabetes at a median time of 3.6 years after delivery. Targeted metabolomics profiles (including 155 metabolites) were obtained during a glucose challenge test. Information on lactation duration was collected by interview during the study visits.

Results: Lactation for > 3 months was associated with higher total lysophosphatidylcholine to total phosphatidylcholine ratio and lower leucine concentrations and lower sum of branched chain amino acids (BCAAs) after adjusting for maternal body mass index, age, educational level, and time since delivery, with correction for multiple testing. Gaussian graphical modelling identified subgroups and networks of closely linked metabolites within the phosphatidylcholine and BCAA groups that were affected by lactation for > 3 months and were linked to the pathophysiology of type 2 diabetes in prior reports.

Conclusions: Our study provides evidence that lactation for > 3 months in women with gestational diabetes may correct several metabolic abnormalities associated with the early pathogenesis of type 2 diabetes, specifically disturbances in the phospholipid and BCAA pathways.