Abstract
Gestational diabetes mellitus (GDM) can cause short- and long-term complications to the mother and fetus. While the precise mechanisms in preserving glucose balance in a healthy pregnancy are unknown, various growth factors and hormones have been implicated or associated with GDM risk in humans or rodents, including prolactin, tumor necrosis factor alpha (TNFα), osteoprotegerin (OPG), hepatocyte growth factor (HGF), and receptor activator of nuclear factor-kappa B ligand (RANKL). We aimed to evaluate the relationship of these and other protein markers in women with GDM. In this cross-sectional study, blood samples were collected from pregnant women with GDM and with normal glucose tolerance (NGT) at the 24- to 32-week obstetrical visit, during the 1-h oral glucose challenge test or 3-h oral glucose tolerance test. Blood plasma was analyzed for RANKL, OPG, prolactin, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), HGF, plasminogen activator inhibitor type 1 (PAI-1), and TNFα. Forty-six women with NGT and 47 women with GDM were included (mean ± standard deviation maternal age 31.6 ± 5.7, mean ± standard deviation gestational age 28.1 ± 2.2 weeks). Groups were similar in terms of age, body mass index, gestational age, and race/ethnicity. Serum levels of OPG, prolactin, TRAIL, HGF, PAI-1, and TNFα were similar in both groups. RANKL was lower in GDM subjects (p = 0.019). Contrary to previous reports in the literature, we found a lower serum RANKL level in women with GDM. Further investigation is needed to determine whether there are suitable serum markers for diagnosing GDM or determining prognosis or severity.
Highlights
Gestational diabetes mellitus (GDM) is a complication of pregnancy with short-term and long-term maternal and fetal consequences
Forty-six women with normal glucose tolerance (NGT) and 47 women with GDM were included in the study
There were no significant differences between subjects with GDM and those without in terms of maternal age, gestational age, body mass index (BMI), mean arterial pressure, and race/ethnicity (Table 1)
Summary
Gestational diabetes mellitus (GDM) is a complication of pregnancy with short-term and long-term maternal and fetal consequences. The incidence of GDM is increasing worldwide, with some reports affecting as high as 10% of pregnancies.[1,2]. GDM is thought to develop as a result of the inability of pancreatic b cells to overcome the natural insulin resistance created by placental hormones in the second half of pregnancy as well as a loss of first phase insulin secretion.[3] Healthy pregnant women adapt to this demand by increasing insulin secretion through b cell hyperplasia and hypertrophy and, as shown in animal models, when this fails to occur, GDM ensues.[4,5,6,7]. Pituitary and placental lactogens are known to play a role in the ability of healthy pregnant women to overcome the increased insulin demands, but the exact molecular mechanisms by which this occurs have yet to be fully elucidated.[8,9] Alterations in inflammatory markers, bone metabolism, and growth factor signaling have been implicated in abnormal glucose tolerance and other diseases in pregnant women.[10,11,12] For example,
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
