Nogueira Anelise Impellizzeri, Souza Santos Robson Augusto, Simões E Silva Ana Cristina, Cabral Antônio Carlos Vieira, Vieira Renata Lúcia Pereira, Drumond Thaís Costa, Machado Lucas José de Campos, Freire Cláudia Maria Vilas, Ribeiro-Oliveira Antônio
Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Av. Professor Alfredo Balena, 190, Santa Efigênia, 30130-100 Belo Horizonte, Minas Gerais, Brazil.
Regul Pept. 2007 Jun 7;141(1-3):55-60. doi: 10.1016/j.regpep.2006.12.014. Epub 2007 Jan 4.
It has been shown that the circulating Renin-Angiotensin System (RAS) is activated during normal pregnancy, but little is known about RAS in pregnancies complicated by gestational diabetes (GDM). GDM is considered not merely a temporary condition, but a harbinger of hypertension and type 2 diabetes. The aim of this study was to evaluate the circulating RAS profile in normotensive women with GDM at the third trimester of pregnancy and to compare the results with healthy pregnant and non-pregnant age-matched women.
The diagnostic criteria for GDM followed the recommendations of the American Diabetes Association. Angiotensin I (Ang I), Angiotensin II (Ang II) and Angiotensin 1-7 [Ang-(1-7)] were determined in 24 pregnant patients with GDM; 12 healthy pregnant women and 12 non-pregnant women by radioimmunoassay.
Levels of Ang I, Ang II and Ang-(1-7) were higher in pregnant women (p<0.05), but showed a different pattern in the GDM group, in which reduced Ang-(1-7) circulating levels were found (p<0.05). This observation was confirmed by the significantly lower Ang-(1-7)/Ang I ratio (p<0.05).
Our data suggest that reduced levels of the vasodilator Ang-(1-7) could be implicated in the endothelial dysfunction seen in gestational diabetic women during and after pregnancy.
研究表明,正常妊娠期间循环肾素-血管紧张素系统(RAS)被激活,但对于合并妊娠期糖尿病(GDM)的妊娠中RAS的了解甚少。GDM不仅被认为是一种暂时的状况,而且是高血压和2型糖尿病的先兆。本研究的目的是评估妊娠晚期患有GDM的血压正常女性的循环RAS概况,并将结果与健康的孕妇和年龄匹配的非孕妇女性进行比较。
GDM的诊断标准遵循美国糖尿病协会的建议。通过放射免疫分析法测定了24例患有GDM的孕妇、12例健康孕妇和12例非孕妇的血管紧张素I(Ang I)、血管紧张素II(Ang II)和血管紧张素1-7 [Ang-(1-7)]。
孕妇的Ang I、Ang II和Ang-(1-7)水平较高(p<0.05),但在GDM组中呈现出不同的模式,其中发现Ang-(1-7)的循环水平降低(p<0.05)。Ang-(1-7)/Ang I比值显著降低证实了这一观察结果(p<0.05)。
我们的数据表明,血管舒张剂Ang-(1-7)水平降低可能与妊娠期间及产后妊娠期糖尿病女性出现的内皮功能障碍有关。