Plasma concentrations of unconjugated estrone, estradiol-17β and estriol, and HCS throughout pregnancy in diabetics and gestational diabetics

Abstract

Summary. Plasma unconjugated estrone (E~), estradiol-17/3 (E2) and estriol (E3) , and HCS were measured in the same plasma samples collected throughout pregnancy in 19 gestational diabetics (GD) and 21 diabetics (D). When compared to the results obtained in 22 normal subjects, plasma levels of E 1 and E 2 were significantly elevated in D in the second half of gestation. The results were intermediate although closer to the normals, in GD. E 3 values were not different from the normals in both D and GD. HCS values were lower than normal in early pregnancy in both D and GD. In late pregnancy HCS levels were not different from normal in either D or GD, although some individual values were much above the upper limit in some diabetic patients. The hormonal ratios in D and GD parallel those in normals, although E3/E 2 and HCS/E 2 were lower in D. These results are discussed with respect to the different behaviour of E 2 and E3, taking into accotmt the difference in their respective biosynthetic pathways. Besides a possible quantitative modification of the placental function in D, the results could tentatively be explained by a qualitative change in the fetal estrogen precursors to placental aromatization, in favour of the 16-non-hydroxylated compound. However, maternal modifications in precursor production or in estrogen metabolism can be an alternative hypothesis. Finally, the present work does not support the hypothetical estrogen deficiency in diabetic pregnancy. Estrogen treatment appears to have no objective justification.* This work was presented at the 1 lth annual meeting of the E. A.S.D., Munich September 1975 (Abstract 46, Diabetologia 11, 337, 1975.Key words: Estrone, estradiol, estriol, estrogens, diabetes, pregnancy, HCS, gestational diabetes, plasma levels.The hormonal environment in diabetic pregnancy has been the subject of many investigations, which have been extensively reviewed recently [1,2]. These works were aimed at showing the possible occurrence of endocrine dysfunction of the placenta, induced by the maternal diabetic environment, or of the fetus where adaptative mechanisms might have been stimulated by the particular metabolic situation. Yet, estrogen administration has been advocated as a necessary part of the treatment in diabetic pregnancy [3], in view of inferred hormonal insufficiency based on urine analysis [1,4].Controversy has arisen concerning the significance of urinary measurements [5], and conflicting results were reported [6]. Plasma measurements of estrogens also gave inconclusive results depending on the technique used, or the selection of patients [1,4,7], regarding for instance their state of equilibrium or the degree of illness. Low [8], high [9][10], and normal [11][12][13][14][15] values were reported for plasma estrogens. High [16,17] and normal [18,19] values were found for plasma HCS (human chorionic somatomammotropin).In the present study, unconjugated estrogens (estrone, estradiol-17/3 and estriol) and HCS were measured in the same plasma samples of a group of well tr...

Metabolic control and serum hormone levels in relation to retinopathy in diabetic pregnancy

“…In 12 of our patients, in whom serum progesterone values at weeks 32-36 of gestation (Fig.2) were high (> 700 nmol/1), the mean placental weight, including the cord and membranes, was 900 g compared with about 600 g in an uncomplicated pregnancy. Elevated serum oestradiol concentration in diabetic pregnancies during the last trimester has been reported [4], but in the present study the mean serum oestradiol level in the diabetic patients did not differ significantly from that in the healthy subjects, although some elevated values were found during the last trimester.…”

Serum levels of human placental lactogen, pregnancy‐associated plasma protein A and endometrial secretory protein PP14 in first trimester of diabetic pregnancy

“…Human placental lactogen (hPL) alters maternal carbohydrate and lipid metabolism in a diabeteslike fashion so as to provide fetal nutrient requirements (1). In diabetic women serum levels of hPL are reported to be normal or above normal in the third trimester (2)(3)(4)(5), which has been attributed to the normal or above normal size of the placenta. In this study we examine whether the diabetic state has an effect on serum hPL levels in first trimester.…”

Hormones of the Placenta: hCG and hPL

“…Diabetes mellitus is associated with a large placenta, and it is therefore not surprising that hPL is generally elevated in this condition M.Cohen et al, 1973;Ursell et al, 1973;Soler et al, 1975;Hertogh et al, 1976;Larinkari et al, 1982;Pledger et al, 1982) (Figure 5.11).…”