Higher prepregnancy body mass index (pBMI) raises gestational diabetes mellitus (GDM) risk. Shared metabolites in early-mid pregnancy may explain this link. Researchers identified such metabolites and tested their mediating effects. The results were published in the Journal of Diabetes Research. 

The study enrolled 100 GDM pregnant women and 100 matched controls. Serum samples taken at 10–20 weeks gestation underwent targeted metabolomic assay. Linear and logistic regression checked pBMI-metabolite-GDM ties. Mediation analysis assessed individual metabolites and clustered latent variables (LVs) on pBMI-GDM association.

Eight metabolites associated with both pBMI and GDM: three organic acids, three acylcarnitines, two fatty acids. Five individual metabolites and two LVs mediated significantly. LV1 (organic acids, branched-chain amino acid biosynthesis) mediated 24.0%; LV2 (acylcarnitines, linoleic acid metabolism) 19.1%. Branched-chain amino acids validated during OGTT.

In this matched cohort, early pregnancy metabolites associated with pBMI and GDM, mediating nearly half the link via key pathways. Cross-sectional findings highlight metabolic targets for future mechanistic studies.