Discussion Questions

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  How can metabolomics be used to identify biomarkers?

  
  
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  What were the authors’ aims?

  
  
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  What was the study design?

  
  
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  What were the statistical challenges?

  
  
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  What information is presented in the tables and figures?

  
  
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  What additional research is needed?

Preeclampsia occurs in 5-8% of pregnancies, most commonly presenting at term as late-onset disease. Primary prevention is an enticing goal, but any strategy would require detection of high-risk women early in pregnancy. In a new study, Bahado-Singh and colleagues demonstrated that metabolomics might help distinguish these patients during the first-trimester.

Application of metabolomics

In short, metabolomics is the comprehensive study of metabolites; for example, the ways in which these small molecules change, interact, or react to modifications in the body’s cells, tissues, or fluids. The field, born in the 1970s, flourished after the human genome was sequenced because investigators could then link metabolite measurements to the genome.

Bahado-Singh and collaborators used metabolomics to look for first-trimester biomarkers of late-onset preeclampsia and to examine their accuracy in predicting late-onset preeclampsia. In addition, they assessed whether metabolomics could be used to discriminate between early- and late-onset preeclampsia. Journal Club members appreciated the possible clinical implications of this investigation: women who are known to be at high-risk for preeclampsia before they are well into a pregnancy would be candidates for future preventative interventions. They also suggested that metabolites most associated with late-onset preeclampsia could play a role in its pathophysiology, and if so, they could serve as targets for research into therapeutic interventions.