Gestational diabetes & diabetes in pregnancy
A three-metabolite microbiota-associated signature for early risk stratification of gestational diabetes mellitus
Authors' conclusion
Early microbiota-associated metabolic dysregulation is detectable before routine GDM diagnosis.
Study context
- Population
- Pregnant women, early pregnancy; Gestational diabetes mellitus (GDM) riskmulticentre
- Participants
- 2,693 women
- Comparison
- Training vs Internal validation vs External cohort A vs External cohort B vs Prospective
- Outcome
- Discrimination (AUC) of a three-metabolite model (3-hydroxydecanoic acid, γ-Glu-Leu, propionic acid) for GDM
Methodological detailsmulticentre, untargeted metabolomics and metagenomics, targeted LC-MS/MS, repeated 10-fold cross-validation, external and prospective validation
- Multicentre
- Untargeted metabolomics and metagenomics
- Targeted LC-MS/MS
- Repeated 10-fold cross-validation
- External and prospective validation
Main finding
As reported in the abstract
Discrimination of later GDM by the three-metabolite model (3-hydroxydecanoic acid, γ-Glu-Leu, propionic acid) · early pregnancy
| Group | AUC | 95% CI |
|---|---|---|
| Training | 0.838 | 0.791-0.885 |
| Internal validation | 0.840 | 0.769-0.911 |
| External cohort A | 0.955 | 0.925-0.985 |
| External cohort B | 0.917 | 0.875-0.958 |
| Prospective | 0.969 | 0.937-1.000 |
AUC
Training0.838
Internal validation0.840
External cohort A0.955
External cohort B0.917
Prospective0.969
95% CI
Training0.791-0.885
Internal validation0.769-0.911
External cohort A0.925-0.985
External cohort B0.875-0.958
Prospective0.937-1.000
Observational data: associations, not effects.
Further findings
Early-pregnancy profile of women who later developed GDM
- Higher BMI, TG and platelet count
Untargeted metabolomics
- Persistently altered metabolites, enriched in energy, oxidative stress and amino acid metabolism pathways
- 14
Metagenomics
- Taxonomic restructuring and coordinated microbiota-metabolite associations
Original publication
A three-metabolite microbiota-associated signature for early risk stratification of gestational diabetes mellitus. Cardiovasc Diabetol. Published 7 August 2026. doi:10.
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