Dąbrowski Filip A, Jarmużek Patrycja, Gondek Agata, Cudnoch-Jędrzejewska Agnieszka, Bomba-Opoń Dorota, Wielgoś Mirosław
Ginekol Pol. 2016;87(9):629-634. doi: 10.5603/GP.2016.0057.
Gestational diabetes mellitus (GDM) is a metabolic disease diagnosed in 1.7% up to 11.6% pregnancies. The prevalence of adverse pregnancy outcome is significantly higher in the case of early onset of diabetes mellitus. Adropin is a hormone promoting carbohydrate oxidation over fat oxidation, and influence nitric oxide synthase. Copeptin is a cleavage product of the vasopressin precursor recently correlated with diabetes mellitus. The aim of the study was to determine maternal serum adropin and copeptin concentrations in women with early and late manifestation of GDM and to discuss their potential role as biochemical markers of insulin resistance.
Case-control study on 58 pregnant Caucasian women. Serum levels of adropin and copeptin were assessed in patients with early onset (GDM1) and classical gestational diabetes mellitus (GDM2). Complications such as macrosomia and hypotrophy were evaluated.
There was no significant difference between the study and the control group (age, BMI, parity). Fetal growth disturbance rate was 37.5% in GDM1, 11% in GDM2 and 6% in controls. Adropin concentration in GDM patients was significantly higher than in control group (p < 0.001), but there was no difference between GDM1 and GDM2 group. High serum concentration of adropin positively correlated with elevated HbA1c (p < 0.05). The groups did not differ in terms of copeptin serum concentration.
High adropin serum concentration in GDM patients is associated with increased risk of fetal growth disturbances, possibly due to improper placentation. According to our prospective study, neither copeptin nor adropin serum concentration are useful to discriminate between early and late onset of gestational diabetes mellitus.
妊娠期糖尿病（GDM）是一种在1.7%至11.6%的妊娠中被诊断出的代谢性疾病。糖尿病早期发病时不良妊娠结局的发生率显著更高。内脂素是一种促进碳水化合物氧化而非脂肪氧化并影响一氧化氮合酶的激素。 copeptin是血管加压素前体的裂解产物，最近与糖尿病相关。本研究的目的是测定早发型和晚发型GDM女性的母体血清内脂素和copeptin浓度，并讨论它们作为胰岛素抵抗生化标志物的潜在作用。
对58名白人孕妇进行病例对照研究。评估早发型（GDM1）和经典妊娠期糖尿病（GDM2）患者的血清内脂素和copeptin水平。评估巨大儿和低体重等并发症。
研究组与对照组（年龄、体重指数、产次）之间无显著差异。GDM1组胎儿生长发育障碍率为37.5%，GDM2组为11%，对照组为6%。GDM患者的内脂素浓度显著高于对照组（p<0.001），但GDM1组和GDM2组之间无差异。血清内脂素浓度高与糖化血红蛋白升高呈正相关（p<0.05）。各组copeptin血清浓度无差异。
GDM患者血清内脂素浓度高与胎儿生长发育障碍风险增加有关，可能是由于胎盘形成不当。根据我们的前瞻性研究，copeptin和血清内脂素浓度均无助于区分妊娠期糖尿病的早发和晚发。
