Abstract

BackgroundPregnant women with mild gestational hyperglycemia present a high risk for hypertension and obesity, and appear to reproduce the model of metabolic syndrome in pregnancy, including hyperinsulinemia and insulin resistance. Diabetic patients have a higher frequency of the IRS-1 Gly972Arg variant and this polymorphism is directly related to insulin resistance and subsequent hyperglycemia. In diabetes, hyperglycemia and other associated factors generate reactive oxygen species that increase DNA damage. The aims of this study were to evaluate the presence of the IRS-1 Arg972 polymorphism in pregnant women with diabetes or mild gestational hyperglycemia, and in their newborns. Additionally, we evaluated the level of primary DNA damage in lymphocytes of Brazilian pregnant women and the relationship between the amount of genetic damage and presence of the polymorphism.MethodsA based on the oral glucose tolerance test (OGTT) results and on glycemic profiles (GP), as follows: non-diabetic group, mild gestational hyperglycemia (MGH) and diabetic group. Eighty-five newborns were included in the study. Maternal peripheral blood samples and umbilical cord blood samples (5–10 mL) were collected for genotyping by PCR-RFLP and for comet assays.ResultsThe prevalence of genotype Gly/Arg in pregnant women groups was not statistically significant. In newborns, the frequency of Gly/Arg was significantly higher in the MGH and diabetic groups than in the non-diabetic group. Taken together, groups IIA and IIB (IIA + IIB; diabetes) presented lower amounts of DNA damage than the non-diabetic group (p = 0.064). No significant association was detected between genetic damage and the presence of the Arg972 genotype in pregnant women.ConclusionThe polymorphism was more prevalent in newborns of diabetic and MGH women. We believe that it is necessary to increase the number of subjects to be examined in order to better determine the biological role of the Arg972 polymorphism in these patients. Despite being classified as low-risk, pregnant women with mild gestational hyperglycemia characterize a population of maternal and perinatal adverse outcomes, and that, together with their newborns, require better monitoring by professionals and health services.

Highlights

  • Maternal hyperglycemia in pregnancy is associated with adverse outcomes, including birth weight ≥90th percentile, delivery by cesarean section, neonatal hypoglycemia, and fetal hyperinsulinemia [1]

  • The mild gestational hyperglycemia (MGH) group presented a lower frequency of newborns with adequate body weight for gestational age (AGA) than the non-diabetic and diabetic groups (p < 0.05)

  • The present study aimed to evaluate the presence of the Arg972 polymorphism of the insulin receptor substrate (IRS)-1 gene in diabetic pregnant women or those with mild gestational hyperglycemia, as well as in their newborns, and to evaluate and correlate with genotoxicity in these pregnant women

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Summary

Introduction

Maternal hyperglycemia in pregnancy is associated with adverse outcomes, including birth weight ≥90th percentile, delivery by cesarean section, neonatal hypoglycemia, and fetal hyperinsulinemia [1]. These associations occur across the full range of increased maternal glucose levels, including those below that classified as overt diabetes [1]. Pregnant women with mild gestational hyperglycemia present a high risk for hypertension and obesity, and appear to reproduce the model of metabolic syndrome in pregnancy, including hyperinsulinemia and insulin resistance. The aims of this study were to evaluate the presence of the IRS-1 Arg972 polymorphism in pregnant women with diabetes or mild gestational hyperglycemia, and in their newborns. We evaluated the level of primary DNA damage in lymphocytes of Brazilian pregnant women and the relationship between the amount of genetic damage and presence of the polymorphism

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