Abstract
BackgroundGestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. GDM is a well known risk factor for foetal overgrowth, termed macrosomia which is influenced by maternal hypergycemia and endocrine status through placental circulation. The study was undertaken to investigate the implication of growth factors and their receptors in GDM and macrosomia, and to discuss the role of the materno-foeto-placental axis in the in-utero regulation of foetal growth.Methods30 women with GDM and their 30 macrosomic babies (4.75 ± 0.15 kg), and 30 healthy age-matched pregnant women and their 30 newborns (3.50 ± 0.10 kg) were recruited in the present study. Serum concentrations of GH and growth factors, i.e., IGF-I, IGF-BP3, FGF-2, EGF and PDGF-B were determined by ELISA. The expression of mRNA encoding for GH, IGF-I, IGF-BP3, FGF-2, PDGF-B and EGF, and their receptors, i.e., GHR, IGF-IR, FGF-2R, EGFR and PDGFR-β were quantified by using RT-qPCR.ResultsThe serum concentrations of IGF-I, IGF-BP3, EGF, FGF-2 and PDGF-B were higher in GDM women and their macrosomic babies as compared to their respective controls. The placental mRNA expression of the growth factors was either upregulated (FGF-2 or PDGF-B) or remained unaltered (IGF-I and EGF) in the placenta of GDM women. The mRNA expression of three growth factor receptors, i.e., IGF-IR, EGFR and PDGFR-β, was upregulated in the placenta of GDM women. Interestingly, serum concentrations of GH were downregulated in the GDM women and their macrosomic offspring. Besides, the expression of mRNAs encoding for GHR was higher, but that encoding for GH was lower, in the placenta of GDM women than control women.ConclusionsOur results demonstrate that growth factors might be implicated in GDM and, in part, in the pathology of macrosomia via materno-foeto-placental axis.
Highlights
Gestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy
Blood Hemoglobin glycoside or clique (HbA1c), insulin and glucose levels Plasma HbA1c levels were statistically higher in GDM women than control mothers (Table 1)
high density lipoprotein (HDL), Low density lipoprotein (LDL)- and totalcholesterol were not altered in macrosomic infants and their mothers compared to respective control subjects (Table 1)
Summary
Gestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. GDM is a well known risk factor for foetal overgrowth, termed macrosomia which is influenced by maternal hypergycemia and endocrine status through placental circulation. The study was undertaken to investigate the implication of growth factors and their receptors in GDM and macrosomia, and to discuss the role of the materno-foeto-placental axis in the in-utero regulation of foetal growth. Excessive birth weight or foetal macrosomia is a common complication of gestational diabetes mellitus (GDM) and is associated with adverse maternal and infantile outcomes including higher rates of postpartum haemorrhage in mothers, perineal lacerations and increased risk for cesarean delivery [1]. We have hypothesized that the accelerated foetal growth, seen in the infants of GDM mothers, may be due to in utero programming, caused by a perturbation in the materno-foeto-placental growth axis [9]. It is noteworthy that the placenta is an important endocrine organ as, during human pregnancy, it produces numerous hormones which may promote early embryonic growth, [15] and influences the fetus by stimulating the production of IGF-I and insulin [16]
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