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Associations Among Biomarkers of Inflammation, Tubular Injury and Lipid Metabolism With Gestational Diabetes Mellitus Status, Microalbuminuria and Retinopathy in the Microalbuminuria and Retinopathy in Gestational Diabetes Study

Published:August 07, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.07.004

      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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