Your browser has javascript turned off or blocked. This will lead to some parts of our website to not work properly or at all. Turn on javascript for best performance.

The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here:

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Paul Franks

Paul Franks

Principal investigator

Paul Franks

Changes in metabolites during an oral glucose tolerance test in early and mid-pregnancy : Findings from the PEARLS randomized, controlled lifestyle trial


  • Danielle E. Haslam
  • Jun Li
  • Liming Liang
  • Marijulie Martinez
  • Cristina Palacios
  • Maria A. Trak-Fellermeier
  • Paul W. Franks
  • Kaumudi Joshipura
  • Shilpa N. Bhupathiraju

Summary, in English

The oral glucose tolerance test (OGTT) is used to diagnose gestational and other types of diabetes. We examined metabolite changes during an OGTT, and how a comprehensive diet and physical activity intervention may influence these changes in a population of overweight/obese Hispanic pregnant women. Integration of changes in metabolites during an OGTT may help us gain preliminary insights into how glucose metabolism changes during pregnancy. Among women from the Pregnancy and EARly Lifestyle improvement Study (PEARLS), we measured metabolites during a multipoint OGTT (fasting, 30, 60 and 120 min) at early and mid-pregnancy. Metabolite levels were measured by liquid chromatography–mass spectrometry in plasma samples in the lifestyle intervention (n = 13) and control (n = 16) arms of the study. A total of 65 candidate metabolites were selected that displayed changes during an OGTT in previous studies. Paired and unpaired t-tests were used to examine differences in ∆fast-120 min: (1) at early and mid-pregnancy; and (2) by intervention assignment. We applied principal component analysis (PCA) to identify those metabolites that differed by intervention assignment and OGTT time points. Most of the characteristic changes in metabolites post-OGTT were similar at both gestational time points. PCA identified characteristic metabolite patterns associated with OGTT time points at both early and mid-pregnancy. These metabolites included ketone bodies, tryptophan, acyl carnitines, polyunsaturated fatty acids, and biomarkers related to bile acid, urea cycle, arginine, and proline metabolism. PCA identified distinct ∆fast-120 min in fatty acid, acyl carnitine, bile acid, ketone body, and amino acid levels at mid-compared to early pregnancy. Participants in the intervention group did not display mean decreases in ∆fast-120 min of several long-chain acyl carnitines that were observed in the control group. These findings provide preliminary insight into metabolites, whose role in increased insulin resistance during pregnancy, should be explored further in future studies.


  • Genetic and Molecular Epidemiology
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year










Document type

Journal article


Multidisciplinary Digital Publishing Institute


  • Public Health, Global Health, Social Medicine and Epidemiology
  • Endocrinology and Diabetes


  • Diet
  • GDM
  • Metabolomics
  • OGTT
  • Omics
  • Physical activity
  • Pregnancy



Research group

  • Genetic and Molecular Epidemiology


  • ISSN: 2218-1989