Loukovaara Mikko J, Loukovaara Sirpa, Leinonen Pekka J, Teramo Kari A W, Andersson Sture H M
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Haartmaninkatu 2, 00290 Helsinki, Finland.
Eur J Obstet Gynecol Reprod Biol. 2005 Feb 1;118(2):160-5. doi: 10.1016/j.ejogrb.2004.11.009.
Endothelial dysfunction has been demonstrated in adult subjects with diabetes. We studied if maternal diabetes is associated with altered endothelial function in the fetus, as this might shed light on mechanisms by which adult diseases are programmed in utero.
Total nitrate/nitrite (NOx) concentration was measured spectrophotometrically with the Griess reagent method. Soluble intercellular adhesion molecule-1 (sICAM-1) concentration was measured by enzyme-linked immunoassay.
Venous cord serum NOx concentration at birth was highest in pregnancies complicated by type 1 diabetes (29.5+/-1.8 micromol/l, n=63) (P<0.0001 versus controls) and lowest in normal pregnancies (19.0+/-1.0 micromol/l, n=56). The concentration was intermediate in pregnancies complicated by gestational diabetes (23.9+/-2.7 micromol/l, n=24), but not significantly higher than in normal pregnancies (P=0.172). Venous cord serum sICAM-1 concentration did not differ between the three groups (P=0.191). Maternal serum NOx concentration in the third trimester was higher in pregnancies complicated by type 1 diabetes (22.9+/-3.4 micromol/l, n=22) than in normal pregnancies (15.4+/-1.4 micromol/l, n=21) (P=0.049).
: Increased cord serum NOx but unaltered sICAM-1 concentration in diabetic pregnancies indicates that maternal diabetes does not cause a general alteration in fetal endothelial function. The increase in cord serum and maternal serum NOx concentration in diabetic pregnancies may be due to abnormalities in insulin-induced nitric oxide release or to a diminished reactivity of the vasculature to the effects of nitric oxide.
在患有糖尿病的成年受试者中已证实存在内皮功能障碍。我们研究了母亲患糖尿病是否与胎儿内皮功能改变有关，因为这可能有助于揭示成人疾病在子宫内编程的机制。
采用格里斯试剂法通过分光光度法测量总硝酸盐/亚硝酸盐（NOx）浓度。通过酶联免疫吸附测定法测量可溶性细胞间粘附分子-1（sICAM-1）浓度。
出生时，1型糖尿病合并妊娠的脐带血清NOx浓度最高（29.5±1.8微摩尔/升，n = 63）（与对照组相比，P<0.0001），正常妊娠的最低（19.0±1.0微摩尔/升，n = 56）。妊娠糖尿病合并妊娠的浓度处于中间水平（23.9±2.7微摩尔/升，n = 24），但不显著高于正常妊娠（P = 0.172）。三组之间脐带血清sICAM-1浓度无差异（P = 0.191）。1型糖尿病合并妊娠的孕妇孕晚期母血NOx浓度（22.9±3.4微摩尔/升，n = 22）高于正常妊娠（15.4±1.4微摩尔/升，n = 21）（P = 0.049）。
糖尿病妊娠中脐带血清NOx升高但sICAM-1浓度未改变，表明母亲患糖尿病不会导致胎儿内皮功能的普遍改变。糖尿病妊娠中脐带血清和母血NOx浓度升高可能是由于胰岛素诱导的一氧化氮释放异常或血管系统对一氧化氮作用的反应性降低。
