Abstract
Objectives
Pregnancy may be complicated by gestational diabetes mellitus (GDM) and/or microvascular
complications like albuminuria, retinopathy and pre-eclampsia. In this study we aimed
to identify whether mechanistic pathways associated with microvascular complications
are active in pregnant women with GDM or microvascular disease.
Methods
Urinary albumin excretion and biomarkers of inflammation, lipoprotein metabolism and
tubular injury were quantified in 355 pregnant women with and without GDM. Participants
underwent fundus photography graded for retinopathy. Adjusted associations between
individual biomarkers and each outcome variable, including GDM status, albuminuria
and retinopathy of interest, were performed using logistic regression.
Results
After adjusting for age, systolic blood pressure, body mass index and ethnicity, significant
associations between GDM status and apolipoprotein A1, interleukin (IL)-6, IL-8, soluble
tumour necrosis factor receptor-I and -II (sTNFR-I and -II), vascular endothelial
growth factor and von Willebrand factor were observed. Increased high-sensitivity
C-reactive protein (hsCRP) and sTNFR-II were associated with higher levels of albuminuria.
hsCRP and previous GDM were associated with retinopathy.
Conclusion
Mechanistic pathways associated with microvascular complications appear to be active
in pregnant women with GDM or microvascular disease.
Résumé
Objectifs
Le diabète sucré gestationnel (DSG) et/ou les maladies microvasculaires, telles l’albuminurie,
la rétinopathie et la prééclampsie, peuvent compliquer la grossesse. Dans la présente
étude, nous avions pour objectif de déterminer si les voies mécanistiques associées
aux complications microvasculaires sont actives chez les femmes enceintes atteintes
du DSG ou d’une maladie microvasculaire.
Méthodes
La quantification de l’excrétion urinaire de l’albumine et des biomarqueurs de l’inflammation,
du métabolisme des lipoprotéines et des lésions tubulaires a été effectuée chez 355
femmes enceintes atteintes ou non du DSG. Les participantes ont eu une photographie
du fond de l’œil calibrée pour dépister la rétinopathie. Les associations ajustées
entre les biomarqueurs individuels et chaque variable d’intérêt, soit le DSG, l’albuminurie
et la rétinopathie, ont été réalisées au moyen de la régression logistique.
Résultats
Après l’ajustement selon l’âge, la pression artérielle systolique, l’indice de masse
corporelle et l’ethnicité, des associations significatives entre le DSG et les apolipoprotéines
A1, l’interleukine (IL)-6, l’IL-8, les récepteurs de type I et de type II du facteur
de nécrose tumorale soluble (sTNFR-I et –II, de l’anglais soluble tumour necrosis factor receptor-I and -II), le facteur de croissance de l’endothélium vasculaire et le facteur von Willebrand
ont été observées. Des concentrations accrues de la protéine C réactive à haute sensibilité
(PCR-hs) et des sTNFR-II ont été associées à des concentrations plus élevées de l’albumine
dans l’urine. La PCR-hs et le DSG antérieur ont été associés à la rétinopathie.
Conclusion
Les voies mécanistiques associées aux complications microvasculaires semblent être
actives chez les femmes enceintes atteintes du DSG ou d’une maladie microvasculaire.
Keywords
Mots clés
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Article Info
Publication History
Published online: August 07, 2022
Accepted:
July 19,
2022
Received in revised form:
June 4,
2022
Received:
January 18,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Canadian Diabetes Association.
