Relationship between C-reactive Protein and Screening Test Results of Gestational Diabetes in Pregnant Women Referred to Health Centers in Isfahan in 2013-2014

Evaluation of first and second trimester maternal thyroid profile on the prediction of gestational diabetes mellitus and post load glycemia

Maternal thyroid alterations have been widely associated with the risk of gestational diabetes mellitus (GDM). This study aims to 1) test the first and the second trimester full maternal thyroid profile on the prediction of GDM, both alone and combined with non-thyroid data; and 2) make that prediction independent of the diagnostic criteria, by evaluating the effectiveness of the different maternal variables on the prediction of oral glucose tolerance test (OGTT) post load glycemia. Pregnant women were recruited in Concepción, Chile. GDM diagnosis was performed at 24-28 weeks of pregnancy by an OGTT (n = 54 for normal glucose tolerance, n = 12 for GDM). 75 maternal thyroid and non-thyroid parameters were recorded in the first and the second trimester of pregnancy. Various combinations of variables were assessed for GDM and post load glycemia prediction through different classification and regression machine learning techniques. The best predictive models were simplified by variable selection. Every model was subjected to leave-one-out cross-validation. Our results indicate that thyroid markers are useful for the prediction of GDM and post load glycemia, especially at the second trimester of pregnancy. Thus, they could be used as an alternative screening tool for GDM, independently of the diagnostic criteria used. The final classification models predict GDM with cross-validation areas under the receiver operating characteristic curve of 0.867 (p<0.001) and 0.920 (p<0.001) in the first and the second trimester of pregnancy, respectively. The final regression models predict post load glycemia with cross-validation Spearman r correlation coefficients of 0.259 (p = 0.036) and 0.457 (p<0.001) in the first and the second trimester of pregnancy, respectively. This investigation constitutes the first attempt to test the performance of the whole maternal thyroid profile on GDM and OGTT post load glycemia prediction. Future external validation studies are needed to confirm these findings in larger cohorts and different populations.

Evaluating pentraxin-3 and hypersensitivity CRP expression in obese pregnancies

OBJECTIVE

This study was designed to evaluate the correlation between serum pentraxin-3 (PTX3)/hypersensitivity CRP (hs-CRP) expression and obesity during pregnancy and their application as inflammatory biomarkers in obese pregnant women.

MATERIALS AND METHODS

Pregnant women scheduled to experience a single-birth at our hospital between 2016 and 2017 were selected for this nested case-control study. These patients were evaluated for age and gestational age in the first trimester (11-14 weeks), had their body mass index (BMI) calculated and were subjected to an OGTT between Week 24 and 28 of pregnancy. Obese patients with normal OGTT and a BMI of ≥30 kg/m² in the second trimester were selected as the obese group (OBE, n = 80), and non-obese pregnant women with normal OGTT with a BMI of <30 kg/m² were selected as the control group (CON, n = 80). ELISA was used to detect the expression of PTX3 and hs-CRP.

RESULTS

The expression of both PTX3 and hs-CRP increased in both groups, with increasing gestational age (P < 0.05). However, hs-CRP level in Group OBE was increased, compared to that in the healthy control (P < 0.01), during the second trimester. PTX3 expression was also significantly higher in OBE samples than in the control (P < 0.05), during the third trimester; correlation analysis demonstrated that PTX3 was positively correlated with hs-CRP, BMI, fasting plasma glucose and HOMA-IR.

CONCLUSIONS

The expression levels of both PTX3 and hs-CRP increased with increasing gestational age, and PTX3 expression was related to BMI, which serves to confirm the inflammatory response in these patients.

Spectrochemical differentiation in gestational diabetes mellitus based on attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy and multivariate analysis

Gestational diabetes mellitus (GDM) is a hyperglycaemic imbalance first recognized during pregnancy, and affects up to 22% of pregnancies worldwide, bringing negative maternal–fetal consequences in the short- and long-term. In order to better characterize GDM in pregnant women, 100 blood plasma samples (50 GDM and 50 healthy pregnant control group) were submitted Attenuated Total Reflection Fourier-transform infrared (ATR-FTIR) spectroscopy, using chemometric approaches, including feature selection algorithms associated with discriminant analysis, such as Linear Discriminant Analysis (LDA), Quadratic Discriminant Analysis (QDA) and Support Vector Machines (SVM), analyzed in the biofingerprint region between 1800 and 900 cm⁻¹ followed by Savitzky–Golay smoothing, baseline correction and normalization to Amide-I band (~ 1650 cm⁻¹). An initial exploratory analysis of the data by Principal Component Analysis (PCA) showed a separation tendency between the two groups, which were then classified by supervised algorithms. Overall, the results obtained by Genetic Algorithm Linear Discriminant Analysis (GA-LDA) were the most satisfactory, with an accuracy, sensitivity and specificity of 100%. The spectral features responsible for group differentiation were attributed mainly to the lipid/protein regions (1462–1747 cm⁻¹). These findings demonstrate, for the first time, the potential of ATR-FTIR spectroscopy combined with multivariate analysis as a screening tool for fast and low-cost GDM detection.

Association of Single Nucleotide Polymorphisms of the IL-6, IL-10, and TNF-α Genes with Susceptibility to Gestational Diabetes Mellitus

Objective: To investigate any associations between the single nucleotide polymorphisms (SNPs) at the interleukin-6 (IL-6) rs1800796, interleukin-10 (IL-10) rs1800896, and the tumor necrosis factor-alpha (TNF-α) rs1800629 loci with gestational diabetes mellitus (GDM) susceptibility. Materials and Methods: A total of 242 GDM patients and 242 healthy controls were enrolled in this study. The genotypes of the IL-6 rs1800796, IL-10 rs1800896, and TNF-α rs1800629 loci were analyzed by Sanger sequencing. Interactions among these SNPs were analyzed through multifactor dimensionality reduction. Results: Women with the IL-6 rs1800796 G allele had a higher GDM susceptibility risk than those with the C allele (odds ratio [OR] = 1.44, 95% confidence interval [CI]: 1.10-1.90, p = 0.010). Women with the IL-10 rs1800896 C allele had a higher risk of GDM susceptibility than those with the T allele (OR = 2.94, 95% CI: 1.87-4.63, p < 0.001). Women with the TNF-α rs1800629 A allele had a higher risk of susceptibility to GDM than those with the G allele (OR = 3.73, 95% CI: 2.25-6.18, p < 0.001). The plasma levels of IL-6 and TNF-α in GDM patients were significantly higher than those in the control group, and the levels of IL-10 were significantly lower than those in the control group (p < 0.001). Women with the IL-6 rs1800796 CG/GG genotypes had higher plasma IL-6 levels than those with the CC genotype (p < 0.05). Women with the IL-10 rs1800896 TT genotype had higher IL-10 levels than those with the TC/CC genotypes (p < 0.05), and those with the TNF-α rs1800629 GA/AA genotypes had higher TNF-α levels than those with the GG genotype (p < 0.05). Conclusion: The results of this study show that the IL-6 rs1800796 G allele, the IL-10 rs1800896 C allele, and the TNF-α rs1800629 A allele are significantly associated with an increased risk of susceptibility to GDM.

Changes of serum pentraxin-3 and hypersensitive CRP levels during pregnancy and their relationship with gestational diabetes mellitus

OBJECTIVE

To investigate the changes of inflammatory factors pentraxin 3 (PTX3) and hypersensitive C-reactive protein (hs-CRP) during pregnancy and their relationship with gestational diabetes mellitus (GDM).

METHODS

The nested case-control study method was used. Eighty non-obese single-pregnant women diagnosed with GDM were included into the case group (GDM, n = 80), together with another eighty pregnant women with normal glucose tolerance were matched in the same period and divided into the control group (CON, n = 80), for detecting multiple biochemical indicators in different pregnancy stages by ELISA.

RESULTS

The serum levels of PTX3 and hs-CRP in pregnant women increased with the increase of gestational age (p < 0.001, p < 0.001). The levels of PTX3 and hs-CRP in group GDM were significantly higher in the middle and late pregnancy stages than group CON (p < 0.01, p < 0.05; p < 0.05, p < 0.05). PTX3 was positively correlated with hs-CRP, body mass index (BMI), fasting plasma glucose (FPG), and homeostasis model assessment of insulin resistance (HOMAIR).

CONCLUSIONS

PTX3 and hs-CRP may be related to the pathogenesis of GDM, and they are significantly increased in the second trimester, which provides a new idea for early prevention and treatment of GDM and risk prediction of long-term cardiovascular diseases.