Association of Acylcarnitines With Maternal Cardiometabolic Risk Factors Is Defined by Chain Length: The S-PRESTO Study
Year: 2024
Type: article
Study design: Observational Study
Abstract: CONTEXT: Due to the essential role of carnitine as an intermediary in amino acid, carbohydrate, and lipid metabolism, a detailed characterization of circulating and urinary carnitine concentrations will aid in elucidating the molecular basis of impaired maternal metabolic flexibility and facilitating timely intervention for expectant mothers. OBJECTIVE: To investigate the association of maternal plasma and urinary free carnitine and acylcarnitines with cardiometabolic risk factors. METHODS: Liquid chromatography tandem mass spectrometry-based quantification of free carnitine and acylcarnitines (C2-C18) was performed on 765 plasma and 702 urine samples collected at preconception, 26 to 28 weeks' pregnancy, and 3 months postpartum in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort study. RESULTS: Plasma concentrations of free carnitine and acylcarnitines decreased coupled with increased renal clearance in pregnancy compared with preconception and postpartum. Renal clearance of carnitine increased with an increase in prepregnancy body mass index (ppBMI) and gestational weight gain. Plasma short-chain acylcarnitines were positively associated with ppBMI, irrespective of the physiological state, while medium- and long-chain acylcarnitines were negatively associated with ppBMI at preconception and postpartum but showed a positive association in pregnancy. Similarly, plasma short-chain acylcarnitines were positively associated with Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) whereas medium- and long-chain acylcarnitines were negatively associated with HOMA-IR at preconception and in pregnancy. Mothers who developed gestational diabetes mellitus during pregnancy had ∼10% higher plasma propionylcarnitine concentration and ∼18% higher urine tiglylcarnitine concentration than mothers with normal glucose metabolism at preconception. CONCLUSION: This study provides the metabolic and physiological basis of maternal carnitine homeostasis, which can be used in assessment of maternal cardiometabolic health at preconception to improve pregnancy outcomes.
Institutions: Agency for Science, Technology and Research, National University of Singapore, Singapore Institute for Clinical Sciences, Life Sciences Institute, KK Women's and Children's Hospital, Duke-NUS Medical School, National University Hospital, National University Health System, Nanyang Technological University, Tan Tock Seng Hospital, University of Auckland, University of Helsinki, Folkhälsans Forskningscentrum
Language: English
Subfield: Clinical Biochemistry
Domain: Life Sciences
Open Access status: bronze
Funders: National Research Foundation, Agency for Science, Technology and Research, National University of Singapore, Singapore Institute for Clinical Sciences, National Research Foundation Singapore, National University Health System, Medical Research Council, National Medical Research Council, Precursory Research for Embryonic Science and Technology
OpenAlex ID: W4394857235