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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 \u223c10% higher plasma propionylcarnitine concentration and \u223c18% higher urine tiglylcarnitine concentration than mothers with normal glucose metabolism at preconception.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae255","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T19:48:37Z","timestamp":1713296917000},"page":"2831-2846","source":"Crossref","is-referenced-by-count":3,"title":["Association of Acylcarnitines With Maternal Cardiometabolic Risk Factors Is Defined by Chain Length: The S-PRESTO 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Gynaecology and Human Potential Translational Research programme, Yong Loo Lin School of Medicine, National University of Singapore , 119228 Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1945-0266","authenticated-orcid":false,"given":"Kok Hian","family":"Tan","sequence":"additional","affiliation":[{"name":"Duke-National University of Singapore (NUS) Medical School , 169857 Singapore ,","place":["Singapore"]},{"name":"Department of Maternal Fetal Medicine, KK Women's and Children's Hospital , 229899 Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry Kok Yen","family":"Chan","sequence":"additional","affiliation":[{"name":"Duke-National University of Singapore (NUS) Medical School , 169857 Singapore ,","place":["Singapore"]},{"name":"Department of Maternal Fetal Medicine, KK Women's and Children's Hospital , 229899 Singapore 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