Methylglyoxal, Glycated Albumin, PAF, and TNF-α: Possible Inflammatory and Metabolic Biomarkers for Management of Gestational Diabetes

Abstract

Background: In gestational diabetes mellitus (GDM), pancreatic β-cell breakdown can result from a proinflammatory imbalance created by a sustained level of cytokines. In this study, we investigated the role of specific cytokines, such as B-cell activating factor (BAFF), tumor necrosis factor α (TNF-α), and platelet-activating factor (PAF), together with methylglyoxal (MGO) and glycated albumin (GA) in pregnant women affected by GDM. Methods: We enrolled 30 women whose inflammation and metabolic markers were measured at recruitment and after 12 weeks of strict dietetic therapy. We compared these data to the data obtained from 53 randomly selected healthy nonpregnant subjects without diabetes, hyperglycemia, or any condition that can affect glycemic metabolism. Results: In pregnant women affected by GDM, PAF levels increased from 26.3 (17.4–47.5) ng/mL to 40.1 (30.5–80.5) ng/mL (p < 0.001). Their TNF-α levels increased from 3.0 (2.8–3.5) pg/mL to 3.4 (3.1–5.8) pg/mL (p < 0.001). The levels of methylglyoxal were significantly higher in the women with GDM (p < 0.001), both at diagnosis and after 12 weeks (0.64 (0.46–0.90) μg/mL; 0.71 (0.47–0.93) μg/mL, respectively) compared to general population (0.25 (0.19–0.28) μg/mL). Levels of glycated albumin were significantly higher in women with GDM (p < 0.001) only after 12 weeks from diagnosis (1.51 (0.88–2.03) nmol/mL) compared to general population (0.95 (0.63–1.4) nmol/mL). Conclusion: These findings support the involvement of new inflammatory and metabolic biomarkers in the mechanisms related to GDM complications and prompt deeper exploration into the vicious cycle connecting inflammation, oxidative stress, and metabolic results.

The relationship between advanced glycation end products and gestational diabetes: A systematic review and meta-analysis

“…MGO was significantly correlated with the HOMA-IR index as well. MGO levels were also positively correlated with both the pregestational and gestational weight of women [ 19 ]. Hence, an HbA1c and HOMA-IR value determined during pregnancy can provide useful information and identify pregnancies that require fetal surveillance [ 66 ].…”

“…The authors also pointed out phytochemical constituents such as genistein and curcumin can sequester highly reactive dicarbonyl compounds such as methylglyoxal and glyoxalase thereby prevent the formation of AGEs and their interaction with RAGE [ 18 ]. Piuri et al also elucidated the possible involvement of new inflammatory and metabolic biomarkers (Methylglyoxal, glycated albumin, PAF, and TNF-α) in the mechanisms related to GDM complications and exploration into the vicious cycle connecting inflammation, oxidative stress, and AGEs [ 19 ]. What is more, AGEs may lead to abnormal expressions of tight junction-associated integral membrane proteins (ZO-1 and Occludin) in vascular endothelial cells of placenta via RAGE/NF-kB signaling pathway, thereby abolishing the integrity of the membrane and increasing placental permeability [ 20 ].…”

Nutrition for Gestational Diabetes—Progress and Potential

“…The subject matters of the final couple of the papers in this Special Issue [ 42 , 43 ] do not fit neatly into the groups of papers described above. Like all forms of diabetes, GDM is thought to result from a combination of insulin resistance and inadequate insulin secretion [ 44 ].…”

“…A number of inflammatory biomarkers are thought to stimulate both enhanced insulin resistance [ 45 ] and reduced insulin secretion in pregnancy [ 46 ], potentially contributing towards the development of GDM or even its complications. In this Special Issue, Piuri and colleagues tracked circulating inflammatory biomarker concentrations in the last trimester of pregnancy in women who were newly diagnosed with GDM which was treated by a (validated) strict adherence to a prescribed diet [ 42 ]. They found that circulating concentrations of tumor necrosis factor-α and platelet-activating factor increased over the final 12 weeks of pregnancy, unlike markers of glucose control which were not surprisingly higher than those observed in non-pregnant, healthy women (suggesting that the dietary treatment of GDM was sub-optimal).…”

“…They found that circulating concentrations of tumor necrosis factor-α and platelet-activating factor increased over the final 12 weeks of pregnancy, unlike markers of glucose control which were not surprisingly higher than those observed in non-pregnant, healthy women (suggesting that the dietary treatment of GDM was sub-optimal). The authors suggested that these inflammatory biomarkers may therefore contribute to the cause or be a consequence of GDM complications [ 42 ]. In the final paper from this Special Issue described in this editorial, Peila and colleagues reviewed one aspect of the influence of GDM after the mother has given birth, that of human breast milk contents [ 43 ].…”