{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T01:39:00Z","timestamp":1781228340148,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01 DK118409"],"award-info":[{"award-number":["R01 DK118409"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01 DK131188"],"award-info":[{"award-number":["R01 DK131188"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT\u2010180576"],"award-info":[{"award-number":["PJT\u2010180576"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007720","name":"Bone and Joint Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007720","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Gestational diabetes mellitus (GDM) poses a significant risk for developing type 2 diabetes mellitus (T2D) and exhibits heterogeneity. However, understanding the link between different types of post\u2010GDM individuals without diabetes and their progression to T2D is crucial to advance personalised medicine approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We employed a discovery\u2010based unsupervised machine learning clustering method to generate clustering models for analysing metabolomics, clinical, and biochemical datasets. For this analysis, we selected 225 women who later developed T2D during the 12\u2010year follow\u2010up period from the cohort of 1010 women who returned to a non\u2010diabetic state at 6\u20139\u00a0weeks (study baseline) after a GDM pregnancy based on 2\u2010h 75\u00a0g research OGTTs. The optimal model was selected by assessing Bayesian Information Criterion values, class separation performance, and the potential for clinically distinguishable clusters, accounting for participant prenatal and early postpartum characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The selected model comprises three clusters: pancreatic beta cell dysfunction (cluster\u2010\u03b2: median HOMA\u2010B 161.3 and median HOMA\u2010IR 3.8), insulin\u2010resistance (cluster\u2010IR: median HOMA\u2010B 630.5 and median HOMA\u2010IR 16.8), and a mixed cluster (cluster\u2010mixed: median HOMA\u2010B 307.2 and median HOMA\u2010IR 8.6). These clusters are distinguishable based on postpartum blood test parameters such as glucose tolerance, HOMA indices, and fasting lipid profiles including triglycerides, leptin, HDL\u2010c, and adiponectin, as well as participant age and BMI. Metabolomic analysis identified unique molecular signatures for each cluster. However, the time to T2D onset was not statistically significant among the three clusters (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.22).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study enhances our understanding of the heterogeneity of early postpartum metabolic profiles that characterise the future onset of T2D diabetes in a diverse cohort of women with GDM, revealing insights into distinct mechanisms and personalised intervention strategies for the prevention of T2D.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70027","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T04:18:38Z","timestamp":1736914718000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Early Postpartum Metabolic Heterogeneity Among Women Who Progressed to Type 2 Diabetes After Gestational Diabetes: A Prospective Cohort"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0990-1695","authenticated-orcid":false,"given":"Saifur R.","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Cardiology University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Vascular Medicine Institute University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"VA Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Center for Immunometabolism University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A. D.","family":"Van","sequence":"additional","affiliation":[{"name":"Departments of Physiology and Medicine University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Xiangyu","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Vascular Medicine Institute University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"VA Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Center for Immunometabolism University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey E.","family":"Alexeeff","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Razani","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Vascular Medicine Institute University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"VA Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Center for Immunometabolism University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Departments of Physiology and Medicine University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica P.","family":"Gunderson","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"},{"name":"Department of Health Systems Science Kaiser Permanente Bernard J. Tyson School of Medicine  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/m15\u20100807"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1361"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18\u20102581"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/565160"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010019\u20100098\u20108"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/grf.0000000000000585"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq267"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dbi20\u20100001"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.101087"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/dmso.s450939"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.32614\/rj\u20102016\u2010021"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995\u2010008\u20100356\u2010y"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11\u20101409"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11634\u2010015\u20100220\u2010z"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14413"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967\u2010018\u20101666\u20105"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15\u20102672"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aog.0000252831.06695.03"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2020.101566"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41556\u2010022\u201001027\u20102"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2018.05.007"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.ra120.012432"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/db15\u20101272"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/2101562"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.987"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/135.9.2103"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep44120"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010019\u201049578\u2010z"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1042\/bj20061645"}],"container-title":["Diabetes\/Metabolism Research and Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dmrr.70027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T06:02:55Z","timestamp":1738130575000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dmrr.70027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/dmrr.70027"],"URL":"https:\/\/doi.org\/10.1002\/dmrr.70027","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1002\/DMRR.70027\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/DMRR.70027\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/DMRR.70027\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/DMRR.70027\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/DMRR.70027\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/DMRR.70027\/v1\/decision1","asserted-by":"object"}]},"ISSN":["1520-7552","1520-7560"],"issn-type":[{"value":"1520-7552","type":"print"},{"value":"1520-7560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-03-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70027"}}