Metabolic alteration of circulating steroid hormones in women with gestational diabetes mellitus and the related risk factors

Na Yang; Wei Zhang; Cheng Ji; Jiajia Ge; Xiaoli Zhang; Meijuan Li; Min Wang; Tianqi Zhang; Jun He; Huaijun Zhu

doi:10.3389/fendo.2023.1196935

Metabolic alteration of circulating steroid hormones in women with gestational diabetes mellitus and the related risk factors

Front Endocrinol (Lausanne). 2023 Jun 15:14:1196935. doi: 10.3389/fendo.2023.1196935. eCollection 2023.

Authors

Na Yang^{1

2}, Wei Zhang³, Cheng Ji¹, Jiajia Ge¹, Xiaoli Zhang², Meijuan Li³, Min Wang¹, Tianqi Zhang¹, Jun He², Huaijun Zhu¹

Affiliations

¹ Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
² Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
³ Nanjing Qlife Medical Technology Co., Ltd, Nanjing, Jiangsu, China.

Abstract

Background: Abnormally changed steroid hormones during pregnancy are closely related to the pathological process of gestational diabetes mellitus (GDM). Our aim was to systematically profile the metabolic alteration of circulating steroid hormones in GDM women and screen for risk factors.

Methods: This study was a case-control study with data measured from 40 GDM women and 70 healthy pregnant women during their 24-28 gestational weeks. 36 kinds of steroid hormones, including 3 kinds of corticosteroids, 2 kinds of progestins, 5 kinds of androgens and 26 kinds of downstream estrogens in serum were systematically measured using a combined sensitive UPLC-MS/MS method. The flux of different metabolic pathways of steroid hormones was analyzed. Logistic regression and ROC curve model analyses were performed to identify potential steroid markers closely associated with GDM development.

Results: Serum corticosteroids, progestins and almost all the estrogen metabolites via 16-pathway from parent estrogens were higher in GDM women compared with healthy controls. Most of the estrogen metabolites via 4-pathway and more than half of the metabolites via 2-pathway were not significantly different. 16α-hydroxyestrone (16OHE1), estrone-glucuronide/sulfate (E1-G/S) and the ratio of total 2-pathway estrogens to total estrogens were screened as three indicators closely related to the risk of GDM development. The adjusted odds ratios of GDM for the highest quartile compared with the lowest were 72.22 (95% CI 11.27-462.71, P _trend <0.001) for 16OHE1 and 6.28 (95% CI 1.74-22.71, P _trend <0.05) for E1-G/S. The ratio of 2-pathway estrogens to total estrogens was negatively associated with the risk of GDM.

Conclusion: The whole metabolic flux from cholesterol to downstream steroid hormones increased in GDM condition. The most significant changes were observed in the 16-pathway metabolism of estrogens, rather than the 2- or 4-pathway or other types of steroid hormones. 16OHE1 may be a strong marker associated with the risk for GDM.

Keywords: UPLC-MS/MS; corticosteroids; estrogens; gestational diabetes; progestins; steroid hormones.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Case-Control Studies
Chromatography, Liquid / methods
Diabetes, Gestational*
Estrogens
Female
Humans
Pregnancy
Progestins
Risk Factors
Tandem Mass Spectrometry

Substances

Progestins
Estrogens

Grants and funding

The project was supported by the National Natural Science Foundation of China (No.82204501, 82204846), Jiangsu Research Hospital Association for Precision Medication (No. JY202109), Nanjing Pharmaceutical Association-Changzhou SiYao Hospital Pharmaceutical Research Fund (2021YX001), Jiangsu Commission of Health Research Fund (No. Z2020053).