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. 2025 Apr 5;30(1):245.
doi: 10.1186/s40001-025-02526-2.

Metabolic profiling and early prediction models for gestational diabetes mellitus in PCOS and non-PCOS pregnant women

Jin Wang #  1   2 , Can Cui #  1   2 , Fei Hou  1   2 , Zhiyan Wu  3 , Yingying Peng  1   2 , Hua Jin  4   5
Affiliations

Metabolic profiling and early prediction models for gestational diabetes mellitus in PCOS and non-PCOS pregnant women

Jin Wang et al. Eur J Med Res. .

Abstract

Background: Gestational diabetes mellitus (GDM) is the most common pregnancy complication, significantly affecting maternal and neonatal health. Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by metabolic abnormalities, which notably elevates the risk of developing GDM during pregnancy.

Methods: In this study, we utilized ultra-high-performance liquid chromatography for untargeted metabolomics analysis of serum samples from 137 pregnant women in the early-to-mid-pregnancy. The cohort consisted of 137 participants, including 70 in the PCOS group (36 who developed GDM in mid-to-late pregnancy and 34 who did not) and 67 in the non-PCOS group (37 who developed GDM and 30 who remained GDM-free). The aim was to investigate metabolic profile differences between PCOS and non-PCOS patients and to construct early GDM prediction models separately for the PCOS and non-PCOS groups.

Results: Our findings revealed significant differences in the metabolic profiles of PCOS patients, which may help elucidate the higher risk of GDM in the PCOS population. Moreover, tailored early GDM prediction models for the PCOS group demonstrated high predictive performance, providing strong support for early diagnosis and intervention in clinical practice.

Conclusions: Untargeted metabolomics analysis revealed distinct metabolic patterns between PCOS patients and non-PCOS patients, particularly in pathways related to GDM. Based on these findings, we successfully constructed GDM prediction models for both PCOS and non-PCOS groups, offering a promising tool for clinical management and early intervention in high-risk populations.

Keywords: Gestational diabetes mellitus; Polycystic ovary syndrome; Prediction models; Untargeted metabolomics analysis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethics committee approval for this study was obtained from the ethics committee of Jinan Maternity and Child Care Hospital (study no: 2024 - 1- 011). Consent for publication: All authors gave consent for the publication. Competing interest: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Overall experimental process. A Study subjects and sample procedure; B metabolotics analysis; C building predictive models
Fig. 2
Fig. 2
Metabolite pattern differences between PCOS and non-PCOS groups. A PCA score plots of PCOS (blue dots) vs. non-PCOS groups (orange dots); B PCOS vs. non-PCOS, cumulative R2X = 0.453 and R2Y = 0.369; C volcano plots of different metabolites in PCOS vs. non-PCOS groups; D heatmap: hierarchical clustering analysis was performed on differential metabolites between PCOS and non-PCOS.
Fig. 3
Fig. 3
Metabolite pattern differences between PCOS and control patients with GDM. A Volcano plots of different metabolites in GDM vs. CON groups; B volcano plots of different metabolites in PCOS–GDM vs. PCOS groups; C heatmap: hierarchical clustering analysis was performed on differential metabolites between GDM and CON; D heatmap: hierarchical clustering analysis was performed on differential metabolites between PCOS–GDM and PCOS; E significantly enriched pathways in GDM vs. CON groups; F significantly enriched pathways in PCOS–GDM vs. PCOS groups. For bubble plots, the color of the dots reflects the enrichment p value, and the size reflects the count of the enriched metabolite. The impact value shows the weight of the metabolite on the pathway
Fig. 4
Fig. 4
Identification of biomarkers using machine learning method. A ROC curve of the top three metabolites in terms of importance in GDM vs. CON groups: AUC value = 0.989; B ROC curve of the top three metabolites in terms of importance in PCOS–GDM vs. PCOS groups: AUC value = 0.908
See this image and copyright information in PMC

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