School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada.
Centre Hospitalier Universitaire de Québec Research Centre et Faculté de médecine, Université Laval, Québec City, Quebec, Canada.
Can J Diabetes. 2014 Oct;38(5):307-13. doi: 10.1016/j.jcjd.2014.02.007. Epub 2014 Jun 28.
The purpose of this study was to investigate circulating concentrations of osteocalcin, a bone-derived protein, while accounting for 25-hydroxyvitamin D (25(OH)D) throughout pregnancy, and whether early gestation concentrations and changes in osteocalcin predict the subsequent diagnosis of gestational diabetes mellitus (GDM).
This was a nested case-control study involving 48 GDM and 48 control pregnant Caucasian women (matched for age, season of conception, pre-pregnancy body mass index and pregnancy length). Maternal serum osteocalcin was measured by enzyme-linked immunosorbent assay and 25(OH)D by chemiluminescence throughout pregnancy (11-13 weeks, 24-28 weeks and predelivery). Differences between groups were compared by mixed model analysis of variance. Predictors of diagnosis of GDM were explored using generalized estimating equation models. Neonatal general health outcomes were also compared between groups.
Serum osteocalcin was higher across pregnancy (p=0.006) in women with GDM vs. controls, whereas serum 25(OH)D was not different (p=0.80). Both biomarkers increased with time across pregnancy (p<0.0001). However, serum osteocalcin during early pregnancy and changes in its concentration from early to mid gestation did not predict the development of GDM. There were no significant differences in anthropometry and APGAR (appearance, pulse, grimace, activity, respiration) scores in neonates of controls and cases.
Serum osteocalcin is elevated in Caucasian women with GDM throughout pregnancy, but was not predictive of the onset of GDM. Larger trials evaluating the role of osteocalcin and the development of GDM appear warranted.
本研究旨在探讨骨钙素(一种来源于骨骼的蛋白)在整个孕期的循环浓度,同时考虑到 25-羟维生素 D(25(OH)D),并研究孕早期骨钙素浓度及其变化是否预测随后发生的妊娠期糖尿病(GDM)。
这是一项巢式病例对照研究,纳入了 48 例 GDM 孕妇和 48 例对照孕妇(按年龄、受孕季节、孕前体重指数和妊娠长度匹配)。采用酶联免疫吸附试验测定孕妇血清骨钙素,采用化学发光法测定 25(OH)D,贯穿整个孕期(11-13 周、24-28 周和分娩前)。采用混合模型方差分析比较组间差异。采用广义估计方程模型探讨 GDM 诊断的预测因素。并比较两组新生儿的一般健康结局。
与对照组相比,GDM 组孕妇整个孕期血清骨钙素均升高(p=0.006),而血清 25(OH)D 无差异(p=0.80)。两种生物标志物在整个孕期均随时间增加(p<0.0001)。然而,孕早期血清骨钙素及其从中孕期到孕晚期的浓度变化并不能预测 GDM 的发生。对照组和病例组新生儿的人体测量学和 APGAR(外观、脉搏、面部表情、活动、呼吸)评分无显著差异。
在整个孕期,患有 GDM 的高加索女性血清骨钙素升高,但不能预测 GDM 的发病。需要更大规模的试验来评估骨钙素的作用及其与 GDM 的发展的关系。