PhD, Faculties of Pharmacy and Medicine, University CEU San Pablo, E-28668, Madrid, Spain.
J Clin Endocrinol Metab. 2013 Aug;98(8):3430-7. doi: 10.1210/jc.2013-1614. Epub 2013 Jun 6.
Angiopoietin-like protein 4 (ANGPTL4) is an extracellular inhibitor of lipoprotein lipase (LPL) activity. No studies have been done in pregnancy in which hypertriglyceridemia and tissue-specific changes in LPL activity are present.
The objective of the study was to determine the relationship between neonatal fat mass (FM) and concentrations of ANGPTL4 and triacylglycerols (TAG) in maternal and cord serum of pregnant women with gestational diabetes mellitus (GDM) compared with controls.
Maternal blood samples (control, n = 90, and GDM, n= 80) and umbilical cord blood were drawn before and after vaginal delivery, respectively. Control and GDM subjects were grouped separately into 3 subgroups, according to neonatal FM: 0-25th percentiles, 25th-75th percentiles, and 75th-100th percentiles.
Glucose, insulin, TAG, nonesterified fatty acids (NEFAs), and ANGPTL4 were determined in maternal and neonatal serum.
Age and pregestational body mass index did not differ between GDM and control women in any subgroups. Maternal serum of GDM pregnant women who delivered the newborn with the highest FM showed the highest concentrations of TAG and NEFAs and lowest concentration of ANGPTL4, despite glucose and insulin concentrations being independent of changes in neonatal FM. However, cord serum of neonates of GDM patients with the highest FM showed higher concentrations of insulin and lower concentrations of TAG than those with lower neonatal FM but no significant differences in NEFAs or ANGPTL4 concentrations.
In well-controlled GDM pregnancies, decreased maternal ANGPTL4 concentrations and a gradient of TAG toward the fetus are related with higher neonatal FM. However, in GDM fetuses with the highest FM, the potential effect of ANGPTL4 inhibiting adipose tissue LPL activity could be overcome by their hyperinsulinemia.
血管生成素样蛋白 4（ANGPTL4）是脂蛋白脂肪酶（LPL）活性的细胞外抑制剂。在妊娠期间，尚未进行过高甘油三酯血症和组织中 LPL 活性的特异性变化的研究。
本研究的目的是确定患有妊娠糖尿病（GDM）的孕妇与对照组相比，其新生儿脂肪量（FM）与母血和脐血中 ANGPTL4 和三酰甘油（TAG）浓度之间的关系。
分别在阴道分娩前后采集母血（对照组，n=90；GDM 组，n=80）和脐血。将对照组和 GDM 组分别按新生儿 FM 分为 3 个亚组：0-25 百分位、25-75 百分位和 75-100 百分位。
检测母血和新生儿血清中的葡萄糖、胰岛素、TAG、非酯化脂肪酸（NEFAs）和 ANGPTL4。
GDM 和对照组的任何亚组之间，年龄和孕前体重指数均无差异。尽管葡萄糖和胰岛素浓度与新生儿 FM 的变化无关，但在分娩出新生儿 FM 最高的 GDM 孕妇的母血中，观察到最高浓度的 TAG 和 NEFAs 以及最低浓度的 ANGPTL4。然而，在新生儿 FM 较高的 GDM 患者的脐血中，胰岛素浓度较高，TAG 浓度较低，但 NEFAs 或 ANGPTL4 浓度无显著差异。
在血糖控制良好的 GDM 妊娠中，母体 ANGPTL4 浓度降低以及向胎儿的 TAG 梯度与较高的新生儿 FM 有关。然而，在新生儿 FM 最高的 GDM 胎儿中，ANGPTL4 抑制脂肪组织 LPL 活性的潜在作用可能被其高胰岛素血症所克服。
