Comment on Kelly et al. Subclinical First Trimester Renal Abnormalities Are Associated With Preeclampsia in Normoalbuminuric Women With Type 1 Diabetes. Diabetes Care 2018;41:120–127

Foussard, Ninon; Cougnard‐Grégoire, Audrey; Rajaobelina, Kalina; Delcourt, Cécile; Helmer, Catherine; Lamireau, T.; Blanco, Laurence; Alexandre, L.; Mohammedi, Kamel; Rigalleau, Vincent

doi:10.2337/dc18-0069

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“…High levels of serum AGEs were also reported in human GDM (31), related to adverse perinatal outcomes such as birth asphyxia, congenital malformations, or stillbirth (32), but not to LGA. AGEs are thought to play a role in preeclampsia (33), and high sAF was reported in former preeclamptic women (34), but they may result from, rather than precede, preeclampsia (35); in our study, blood pressures during pregnancy were not associated with macrosomia. The role of AGEs has also been suspected in neural tube defects (36) and autism (37) that have been related to diabetic pregnancies (38,39).…”

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confidence: 42%

Skin Autofluorescence of Pregnant Women With Diabetes Predicts the Macrosomia of Their Children

et al. 2019

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Advanced glycation end products (AGEs) accumulated during long-term hyperglycemia are involved in diabetes complications and can be estimated by skin autofluorescence (sAF). During pregnancy, hyperglycemia exposes women to the risk of having a macrosomic newborn. The aim of this study was to determine whether sAF of women with diabetes during a singleton pregnancy could predict macrosomia in their newborns. Using an AGE Reader, we measured the sAF at the first visit of 343 women who were referred to our diabetology department during years 2011-2015. Thirty-nine women had pregestational diabetes, 95 early gestational diabetes mellitus (GDM), and 209 late GDM. Macrosomia was defined as birth weight ‡4,000 g and/or large for gestational age ‡90th percentile. Forty-six newborns were macrosomic. Their mothers had 11% higher sAF compared with other mothers: 2.03 6 0.30 arbitrary units (AUs) vs. 1.80 6 0.34 (P < 0.0001). Using multivariate logistic regression, the relation between sAF and macrosomia was significant (odds ratio 4.13 for 1-AU increase of sAF [95% CI 1.46-11.71]) after adjusting for several potential confounders. This relation remained significant after further adjustment for HbA 1c (among 263 women with available HbA 1c ) and for women with GDM only. sAF of pregnant women with diabetes, a marker of long-term hyperglycemic exposure, predicts macrosomia in their newborns.

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