C1q/TNF-Related Protein-3 (CTRP-3) and Pigment Epithelium-Derived Factor (PEDF) Concentrations in Patients with Gestational Diabetes Mellitus: A Case-Control Study

Abstract

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.

High Serum Levels of Afamin and Tumor Necrosis Factor-α during The First Trimester might be used as Early Predictors for Gestational Diabetes Mellitus in Euglycemic Pregnant women

“…The obtained results and literature review point to a role of disturbed levels of adipocytokines and hepatokines during pregnancy in development of gestational glucose intolerance and the progress to diabetic state. This explanation supported that previously detected by Francis et al [34] and Gęca et al [35] who documented a possible role for disturbed levels of diabetogenic factors secreted by either or both of adipose tissue and hepatocytes in development of GDM.…”

Estimation of Glycated Hemoglobin A (HbA1c) at time of Pregnancy Diagnosis as a discriminative Early test for Women vulnerable to develop Gestational Diabetes Mellitus at the 24th Gestational Week

“…studied panel of adipokines; fatty acid binding protein-4, chemerin, and soluble leptin receptor and indicated a role for these adipokines in the pathogenesis of GDM with significant associations detected early in pregnancy before typical GDM screening time. Also, Gęca et al, [29] found serum concentrations of C1q/tumor necrosis factor-related protein-3, one of adipokines, were significantly higher in women with GDM, irrespective of being diet-or insulin treated or not treated at all in comparison to levels estimated in control group. Interestingly, at time of diagnosis of pregnancy, women who developed GDM were found to have significantly higher BMI than non-GDM women and statistical correlations detected a positive significant correlation between BMI at time of pregnancy diagnosis and severity of GDM as judged by 2-hr PPBG during glucose tolerance testing at 24 th GW.…”

“…These findings point to a fact that pregnancy is a diabetogenic state, but certain women were vulnerable to manifest diabetic BG levels and go in hand with Li et al [28] who found the levels of FBG, PPBGG and insulin resistance scorings were significantly higher in GDM than in normal glucose tolerance women who showed progressive increase of their FBG and PPBG but do not approach the diagnostic level of GDM. Explanation of pathogenesis of gestational glucose intolerance is extremely important, but was still indefinite [29] and Li et al, [28] attributed it to progressively declining pancreatic β-cell function as manifested by increased insulin resistance scorings. As another explanation, disturbed levels of adipokines, which are secreted by adipose tissue, during pregnancy may play an important role in pathogenesis of gestational hyperglycemia, insulin resistance and progression to GDM.…”

Excessive Pregestational Weight and Maternal Obstetric Complications: The Role of Adipokines

“…In extravillous trophoblast cells, hypoxia induces overexpression of PEDF, which is associated with increased apoptosis and decreased invasiveness that may be implicated in placental defects in PE [119]. It has been observed that PEDF concentrations are higher in women with GDM than in controls and significantly predict the development of DM2 at 3 months postpartum [120]; however, another study reports no difference in PEDF concentrations between women with GDM and controls [121].…”