GUT MICROBIOTA METABOLITE PROFILES IN THIRD-TRIMESTER PREGNANT WOMEN AND INFANTS FOR DIABETES MELLITUS BIOMARKER EXPLORATION: A NARRATIVE REVIEW
Abstract
ABSTRAK
Diabetes melitus merupakan beban kesehatan global yang terus meningkat. Masa kehamilan trimester ketiga dan masa bayi merupakan jendela kritis pemrograman metabolik, dan mikrobiota usus beserta metabolitnya diduga berperan dalam gangguan metabolisme glukosa. Tinjauan ini bertujuan mengeksplorasi bukti terkini mengenai profil metabolit mikrobiota usus pada ibu hamil trimester ketiga dan bayi, serta potensinya sebagai biomarker DM. Penelusuran literatur dilakukan pada PubMed, Scopus, EBSCOhost, dan Google Scholar (2012–2025) menggunakan kata kunci terkait mikrobiota usus, metabolomik, kehamilan trimester ketiga, bayi, dan diabetes melitus. Perubahan komposisi mikrobiota usus pada trimester ketiga dikaitkan dengan resistensi insulin fisiologis dan, pada sebagian ibu, dengan diabetes melitus gestasional. Penurunan Akkermansia muciniphila dan Faecalibacterium prausnitzii serta perubahan metabolit seperti asam lemak rantai pendek, asam amino rantai cabang, trimetilamina N-oksida, dan asam empedu dilaporkan pada DMG. Mikrobiota ibu berperan dalam kolonisasi usus bayi, dan disbiosis awal kehidupan berhubungan dengan risiko gangguan metabolik di kemudian hari. Metabolit turunan mikrobiota usus ibu-bayi menjanjikan sebagai biomarker deteksi dini DM, tetapi diperlukan studi kohort prospektif berskala besar, standardisasi platform metabolomik, serta studi kausal sebelum aplikasi klinis.
ABSTRACT
Diabetes mellitus is a growing global health burden. The third trimester of pregnancy and infancy are critical windows of metabolic programming, and gut microbiota with their metabolites are proposed to play a role in glucose metabolism disturbances. This review aimed to explore current evidence on gut microbiota metabolite profiles in third-trimester pregnant women and infants, and their potential as DM biomarkers. A literature search was performed in PubMed, Scopus, EBSCOhost, and Google Scholar (2012–2025) using keywords related to gut microbiota, metabolomics, third-trimester pregnancy, infants, and diabetes mellitus. Gut microbiota compositional shifts in the third trimester have been linked to physiological insulin resistance and, in some women, to gestational diabetes mellitus. Depletion of Akkermansia muciniphila and Faecalibacterium prausnitzii, together with altered metabolites, including short-chain fatty acids, branched-chain amino acids), trimethylamine N-oxide, and bile acids, has been reported in GDM. Maternal microbiota contributes to infant gut colonization, and early-life dysbiosis has been associated with later metabolic risk. Gut microbiota-derived metabolites in mother–infant dyads are promising for early DM biomarker discovery, but large prospective cohorts, metabolomics standardization, and causal studies are required before clinical application.
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