Infant urinary amino acid and acylcarnitine concentrations varied by maternal diabetes and gestational age and were differentially related to postnatal adiposity in the preterm diabetes-exposed group, with factor 4 score (fatty acid and amino acid metabolites) associated with triceps skinfold thickness and mid arm circumference.
Key Findings
Methods
The study cohort consisted of 91 infants, of whom 25 were exposed to maternal diabetes and 68 were preterm.
91 total infants enrolled
25 (27%) were exposed to diabetes in pregnancy
68 (75%) were preterm, with gestational age range of 30-36 weeks
Body composition assessments were completed at hospital discharge
Urine samples were collected in the first week of life for targeted metabolomics
Results
Factor 4 score, representing fatty acid and amino acid metabolites, was associated with triceps skinfold thickness in the preterm-DM group.
β = 1.67 (95% CI: 0.62, 2.72) for association with triceps skinfold thickness
Association was identified specifically in the preterm-DM subgroup
Factor 4 was derived from factor analysis of urinary metabolites
Quantile regression was used to evaluate associations
Results
Factor 4 score was associated with mid arm circumference in the preterm-DM group.
β = 1.59 (95% CI: 0.70, 2.49) for association with mid arm circumference
Association was identified specifically in the preterm-DM subgroup
Both triceps skinfold thickness and mid arm circumference were used as measures of adiposity
Results
Urinary acylcarnitines C2, C3, and ornithine were decreased in the diabetes-exposed group.
Fold change < 0.67 for C2, C3, and ornithine in the DM group
p < 0.01 for these associations
These decreases were observed in urine samples from the first week of life
Results
Urinary C0, C2, C3, C5, ornithine, proline, and lysine were increased in the preterm group compared to term infants.
Fold change > 2.7 for C0, C2, C3, C5, ornithine, proline, and lysine in the preterm group
p < 0.0001 for these associations
Both acylcarnitines and amino acids were elevated in preterm infants
Results
Urinary metabolite signatures varied by both maternal diabetes status and gestational age and were differentially related to postnatal adiposity.
Differential relationships with adiposity were observed specifically in the preterm DM-exposed group
Unique signatures of urinary metabolites may reflect early metabolism changes in the developing infant
Both amino acids and acylcarnitines contributed to the differential metabolite patterns