scholarly journals Assessment of the SFlt-1 and sFlt-1/25(OH)D Ratio as a Diagnostic Tool in Gestational Hypertension (GH), Preeclampsia (PE), and Gestational Diabetes Mellitus (GDM)

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Malgorzata Walentowicz-Sadlecka ◽  
Piotr Domaracki ◽  
Pawel Sadlecki ◽  
Joanna Siodmiak ◽  
Marek Grabiec ◽  
...  

Background. Placental soluble fms-like tyrosine kinase-1 (sFlt-1), an antagonist of vascular endothelial growth factor, is considered an etiological factor of endothelial damage in pregnancy pathologies. An increase in the sFlt-1 level is associated with alterations of endothelial integrity. In contrast, vitamin D exerts a protective effect and low concentrations of 25(OH)D may have an adverse effect on common complications of pregnancy, such as gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM). The aim of this study was to analyze the levels of sFlt-1 in Polish women with physiological pregnancies and pregnancies complicated by GH, PE, and GDM. Moreover, we analyzed relationships between the maternal serum sFlt-1 level and the sFlt-1 to 25(OH)D ratio and the risk of GH and PE. Material and Methods. The study included 171 women with complicated pregnancies; among them are 45 with GH, 23 with PE, and 103 with GDM. The control group was comprised of 36 women with physiological pregnancies. Concentrations of sFl-1 and 25(OH)D were measured before delivery, with commercially available immunoassays. Results. Women with GH differed significantly from the controls in terms of their serum sFlt-1 levels (5797 pg/ml vs. 3531 pg/ml, p=0.0014). Moreover, a significant difference in sFlt-1 concentrations was found between women with PE and those with physiological pregnancies (6074 pg/ml vs. 3531 pg/ml, p<0.0001). GDM did not exert a statistically significant effect on serum sFlt-1 levels. Both logistic regression and ROC analysis demonstrated that elevated concentration of sFlt-1 was associated with greater risk of GH (AUC=0.70, p=0.0001) and PE (AUC=0.82, p<0.0001). Also, the sFlt-1 to 25(OH)D ratio, with the cutoff values of 652 (AUC=0.74, p<0.0001) and 653 (AUC=0.88, p<0.0001), respectively, was identified as a significant predictor of GH and PE. Conclusions. Determination of the sFlt-1/25(OH)D ratio might provide additional important information and, thus, be helpful in the identification of patients with PE and GH, facilitating their qualification for intensive treatment and improving the neonatal outcomes.


2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.



2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Mengyuan Tian ◽  
Shujuan Ma ◽  
Yiping You ◽  
Sisi Long ◽  
Jiayue Zhang ◽  
...  

Objective. Gestational diabetes mellitus (GDM) is a common metabolic disorder with onset during pregnancy. However, the etiology and pathogenesis of GDM have not been fully elucidated. In this study, we used a metabolomics approach to investigate the relationship between maternal serum metabolites and GDM in early pregnancy. Methods. A nested case-control study was performed. To establish an early pregnancy cohort, pregnant women in early pregnancy ( 10 ‐ 13 + 6 weeks) were recruited. In total, 51 patients with GDM and 51 healthy controls were included. Serum samples were analyzed using an untargeted high-performance liquid chromatography mass spectrometry metabolomics approach. The relationships between metabolites and GDM were analyzed by an orthogonal partial least-squares discriminant analysis. Differential metabolites were evaluated using a KEGG pathway analysis. Results. A total of 44 differential metabolites were identified between GDM cases and healthy controls during early pregnancy. Of these, 26 significant metabolites were obtained in early pregnancy after false discovery rate ( FDR < 0.1 ) correction. In the GDM group, the levels of L-pyroglutamic acid, L-glutamic acid, phenylacetic acid, pantothenic acid, and xanthine were significantly higher and the levels of 1,5-anhydro-D-glucitol, calcitriol, and 4-oxoproline were significantly lower than those in the control group. These metabolites were involved in multiple metabolic pathways, including those for amino acid, carbohydrate, lipid, energy, nucleotide, cofactor, and vitamin metabolism. Conclusions. We identified significant differentially expressed metabolites associated with the risk of GDM, providing insight into the mechanisms underlying GDM in early pregnancy and candidate predictive markers.



Author(s):  
Jenniferbritto John ◽  
Mary Mahendran

Background: Obesity in Indian women had increased from 10.6% to 14.8% in India. Mothers who are overweight or obese during pregnancy and childbirth cause significant antenatal, intrapartum, postpartum and also neonatal complications. The present study aimed to explore various maternal and fetal outcomes influenced by maternal obesity. The objective was to find the effect of obesity on maternal and perinatal outcome among obese pregnant women compared to those of normal weight.Methods: The study was conducted in antenatal women attending antenatal outpatient department of CSI rainy multispecialty hospital located in North Chennai of South India. Consecutive sampling method was followed to include 50 cases and 50 controls. Analysis was done with IBM SPSS v.21.0. Chi square test was applied to find difference between proportions. For comparison of means independent t-test and ANOVA was applied. Pearson's correlation was done to find association between maternal BMI and birth weight.Results: Sixteen (32%) cases developed gestational diabetes mellitus during their antenatal period and 19 (38%) developed gestational hypertension. 10% underwent in emergency caesarean section and in 28% cases elective caesarean section was done. The proportion of cases who developed ante partum complications including gestational diabetes mellitus, gestational hypertension and preeclampsia were higher than in control groups (p value = 0.03,0.00,0.004 respectively). The need for induction of labour and caesarean section was found to be higher in cases than in controls (p = 0.014,0.03 respectively). Increased NICU admissions for stabilization of the newborn among cases was higher than control group (p = 0.012).Conclusions: It was clearly evident from the present study that maternal obesity had adverse maternal and fetal outcomes. Maternal obesity was strongly associated with antenatal complications like gestational diabetes mellitus, gestational hypertension, preeclampsia and increase in need for induction of labour and operative interference.



2020 ◽  
Vol 9 (8) ◽  
pp. 2587
Author(s):  
Tomasz Gęca ◽  
Maciej Kwiatek ◽  
Arkadiusz Krzyżanowski ◽  
Anna Kwaśniewska

Background: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnant women, defined as any degree of glucose intolerance with onset or first detected during pregnancy. Explanation of its pathogenesis is extremely important due to the possibility of preventing serious maternal and fetal complications. The aim of the study was to evaluate the concentrations of two molecules: C1q/tumor necrosis factor-related protein-3 (CTRP-3) and pigment epithelium-derived factor (PEDF) which may possibly participate in GDM development. To our knowledge, this is the first study in pregnant women with GDM evaluating CTRP-3 level. Methods: Serum CTRP-3 and PEDF concentration and clinical characteristics were detected in 172 pregnant women. These women were divided into two groups: normal glucose tolerance group (NGT, n = 54) and gestational diabetes mellitus group (GDM, n = 118). This second group was further divided into two subgroups depending on the treatment used: GDM 1—diet only (n = 75) and GDM 2—insulin treatment (n = 43). Results: Our study did not reveal any statistically significant difference between the concentration of PEDF in the control and GDM group. In our study there was a significantly higher concentration of CTRP-3 evaluated in the peripheral blood serum in patients with gestational diabetes (GDM) compared to those in the control group (8.84 vs. 4.79 ng/mL). Significantly higher values of CTRP-3 were observed in both the diet-treated subgroup and the group with insulin therapy when compared to control group (8.40 and 10.96, respectively vs. 4.79 ng/mL). Conclusion: PEDF concentration does not change in GDM, whereas an increased level of CTRP-3 may point to the key role of this adipokine in the development of GDM.



Author(s):  
Riham M. Enab ◽  
Amal A. El Sokary ◽  
Heba A. Mourad ◽  
Amal E. Mahfouz

Background: Vitamin D3 is synthesized in skin and sequentially metabolized in liver and kidney in humans. It is well known for its function in maintaining calcium and phosphorus homeostasis and promoting bone mineralization. The primary objective of this study was to evaluate vitamin D3 level in pregnant women who were suffering from gestational diabetes mellitus and comparing it with the control groups. Materials and Methods: This case control study was conducted on 100 pregnant women who were attending the inpatient and outpatient clinics of Obstetrics department, Tanta University Hospital, who were divided into two equal groups.Group A (control group): Fifty apparently healthy pregnant women at 24th-28th weeks of gestation. Group B (study group): Fifty pregnant women had gestational diabetes. Results: There is significant increase between the two studied groups according to HbA1c, also there is decrease between the two groups as regards VIT D. Mean HbA1c % was statistically significant higher in the study group versus control group. There was statistical significant difference noted between mean serum level of vitamin D among the two studied groups. A statistically significant negative correlation was observed between serum 25 OH vitamin D and HbA1c among our cases (r=- 0.745) (p ≤ 0.001). Mean serum vitamin D was significantly lower in cases with complications than those with normal outcome. Conclusion: Vitamin D deficiency may have a positive relationship with gestational diabetes mellitus.



2020 ◽  
Vol 28 (2) ◽  
pp. 89-94
Author(s):  
Aşkın Evren Güler ◽  
Zeliha Çiğdem Demirel Güler ◽  
Asil Budak ◽  
Buket Koparal ◽  
Özge Şehirli Kıncı

Objective The aim of this study was to investigate the anxiety levels of pregnant women with gestational diabetes mellitus (GDM) followed by different treatment methods. Methods Our study was carried out with 141 cases whose pregnancy follow ups were made in Gynecology and Obstetrics Clinic. Cases which had GDM screening with 75-g oral glucose tolerance test (OGTT) were divided into 3 groups. Group 1 (control group) consisted of 50 cases with 75-g OGTT results in normal range, Group 2 consisted of 50 cases which had significant 75-g OGTT results and followed up by diet (A1), and Group 3 consisted of 41 cases which were diagnosed with GDM as a result of 75-g OGTT and received diet as well as medical therapy (A2). Beck anxiety inventory (BAI) was administered to the patients in Group 1 in 24th week, and to patients in Groups 2 and 3 in the 24th and 32nd weeks. Results In the first evaluation of the patients, BAI scores of the control group were statistically found to be significantly lower than the patients with GDM (p=0.001). There was no significant difference in BAI scores among patients diagnosed with GDM, and high anxiety scores were found in both groups. There was a significant decrease in anxiety levels in the Groups 2 and 3 after the treatment (p<0.01). In the Group 2, the BAI scores were observed to decrease from 51.76±4.47 to 45.62±3.65, and from 51.73±5.27 to 41.48±3.29 in the Group 3 (p<0.001). Conclusion In addition to the metabolic disorders brought by the disease itself, GDM can cause various problems by increasing the levels of anxiety in patients. With an effective treatment for glycemic control, anxiety levels of patients can be reduced.



2017 ◽  
Vol 8 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Farzana Akonjee Mishu ◽  
MA Muttalib ◽  
Bilkis Sultana

Background: The term gestational diabetes mellitus (GDM) is becoming a major health problem in developing countries undergoing rapid changes in lifestyle, dietary habits and body mass index. GDM is associated with an increased incidence of congenital abnormalities which is also aggravated by mother’s zinc and copper deficiency. Zinc and copper are essential trace elements for normal embryogenesis and fetal growth and their deficiency increase mortality and morbidity of mothers, embryos and neonates. This study was designed to evaluate the association of serum zinc and copper with GDM in second and third trimester.Methods: It was a case-control study. This study was conducted in Mymensingh Medical College Hospital during the period from July 2013 to June 2014 to evaluate the association of zinc and copper levels of pregnant women with GDM. A total induded of 172 subjects were participated in this study; among them 86 women diagnosed with GDM were selected as case (Group-I) and 86 healthy pregnant women were control (Group- II).The case group was again subdivided as Group Ia and Ib according to second and third trimester respectively. Control group was also subdivided as Group IIa and IIb according to second and third trimester respectively. Student’s unpaired ‘t’ test was used to analyse the data between groups. For analytical purpose 95% confidence limit (p<0.05) was taken as level of significance.Results: There was significant difference in serum zinc and copper levels in cases compared to control group. Highly significant difference (p<0.001) was found when serum zinc was compared between women with GDM and normoglycemic pregnant women in second and third trimester. Serum copper level was significantly increased in cases compared to control group in second trimester and the difference was found highly significant (p<0.001) and significant difference (p<0.01) was found in GDM compared to normoglycemic pregnant women in third trimester.Birdem Med J 2018; 8(1): 52-55



2019 ◽  
pp. 1-4
Author(s):  
Derya Ece Iliman ◽  
Ibrahim Karaca ◽  
Levent Yasar ◽  
Keziban Dogan ◽  
Raziye Kıcık Calıskan

Objective: In this study we aimed to compare blood count parameters such as; mean platelet volume (MPV), platelet count (PC), and platelet distribution width (PDW), white blood count (WBC), hemoglobin (HMG), hematocrit (HCT), lymphocyte (LYM ), neutrophil (NEU), PC/MPV, PC/LYM, PC/WBC, NEU/LYM rates; between healthy pregnant women and pregnant women with Gestational Diabetes Mellitus (GDM) whether these parameters have a predictive value of GDM. Methods: A retrospective case control study was performed and a total of 202 pregnant women including 78 pregnant women with GDM (38.6%) and 124 healthy pregnant women (61.4%; the control group) were fallen under the study. Prior medical histories had no particularity. Results: The result of compared parameters between GDM and Control Groups; there was no significant difference between any variables except age (p=0.024; p<0.05). Conclusion: If blood samples are evaluated under healthy conditions ( rapidly collection, transfer and studying) we concluded that blood count parameters would not be useful for predicting the diagnosis of GDM.



2018 ◽  
Vol 42 (4) ◽  
pp. 149-154
Author(s):  
Seçkin Özgür Tekeli ◽  
Feyza Yağmur Tekeli ◽  
Onur Erol ◽  
Hamit Yaşar Ellidag ◽  
Esin Eren ◽  
...  

AbstractBackgroundVitamin D affects glucose metabolism by increasing insulin secretion and insulin receptor expression. Also, it exerts these effects by binding to its primary receptor, the vitamin D receptor (VDR). In this preliminary study, we aimed to examine serum 25-(OH) vitamin D3and serum VDR levels in gestational diabetes mellitus (GDM) patients.MethodsBlood samples were obtained during 24–28 weeks of pregnancy from patients with GDM (n=30) and age, body mass index (BMI), and gestational age-matched control subjects (n=33). Both groups were examined for changes in the levels of glucose, insulin, glycated hemoglobin (bA1c), 25-(OH) vitamin D3and VDR.ResultsThere were no significant differences in serum 25-(OH) vitamin D3and fasting insulin levels between the control and GDM groups (p=0.115, p=0.182). But serum VDR levels were significantly higher in the GDM group than in the control group (p=0.001).ConclusionsAlthough there was no significant difference between the two groups regarding 25-(OH) vitamin D3levels, it is notable that VDR levels were higher in GDM patients. To further define the role of vitamin D in the prophylaxis and treatment of GDM, it may be useful to conduct more extensive studies on VDR.



2015 ◽  
Vol 12 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Md Rafiqul Alam ◽  
Md Abdul Momen ◽  
Anjuman Ara Sultana ◽  
SM Nurul Hassan

Objective: The umbilical cord is fetal organ and contains two arteries and one vein covered by connective tissue called Wharton’s jelly. Gestational diabetes mellitus (GDM) is a common metabolic disorder, the importance of which includes possible fetal and maternal complications. As the umbilical cord is the communicating channel between the fetus and the placenta, any pathological change in the umbilical cord may cause harm to the fetus. For this reason, some gross morphological and microscopic features of umbilical cord were analyzed in case of pre-gestational and gestational diabetes mellitus. Materials and Methods: A cross-sectional, analytical and observational type of study was carried out in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between July 2004 and December 2005. Total 60 umbilical cords with placentae were collected within 34 to 40 weeks of gestation from BSMMU and BIRDEM. Among these, twenty were from mothers not suffering from diabetes (Control group), twenty had pre-gestational diabetes mellitus (PDM group) and twenty were suffering from gestational diabetes mellitus (GDM group). Number of umbilical vessels were observed on the cut surface of umbilical cord later confirmed by histological examination. Presence or absence of true or false knots were noted. The umbilical cord cross sectional area, vessel areas and their luminal area were estimated. The ANOVA post-hoc option was used for statistical analyses of results. Results: Among the gross and histomorphological variables of the umbilical cord, there was no significant difference between the three groups. DOI: http://dx.doi.org/10.3329/bja.v12i1.22615 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 25-29



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