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妊娠期糖尿病筛查阳性但诊断阴性的孕妇全血细胞的基因表达谱存在差异。

Gene expression profile of whole blood cells differs in pregnant women with positive screening and negative diagnosis for gestational diabetes.

作者信息

Gelaleti Rafael B, Damasceno Débora C, Salvadori Daisy M F, Calderon Iracema M P, Costa Roberto A A, Piculo Fernanda, Martins David C, Rudge Marilza V C

机构信息

Department of Gynecology and Obstetrics , Botucatu Medical School, UNESP_Univ Estadual Paulista, Laboratory of Experimental Research in Gynecology and Obstetrics , Botucatu , Brazil.

Department of Pathology , Botucatu Medical School, UNESP_Univ Estadual Paulista, Laboratory of Toxicogenomics and Nutrigenomics , Botucatu , Brazil.

出版信息

BMJ Open Diabetes Res Care. 2016 Oct 13;4(1):e000273. doi: 10.1136/bmjdrc-2016-000273. eCollection 2016.

Abstract

OBJECTIVE

To evaluate the gene expression profile of whole blood cells in pregnant women without diabetes (with positive screening and negative diagnosis for gestational diabetes mellitus (GDM)) compared with pregnant women with negative screening for GDM.

RESEARCH DESIGN AND METHODS

Pregnant women were recruited in the Diabetes Perinatal Research Centre-Botucatu Medical School-UNESP and Botucatuense Mercy Hospital (UNIMED). Distributed into 2 groups: control (n=8), women with negative screening and non-diabetic (ND, n=13), with positive screening and negative diagnosis of GDM. A peripheral blood sample was collected for glucose, glycated hemoglobin, and microarray gene expression analyses.

RESULTS

The evaluation of gene expression profiles showed significant differences between the control group and the ND group, with 22 differentially expressed gene sequences. Gene networks and interaction tables were generated to evaluate the biological processes associated with differentially expressed genes of interest.

CONCLUSIONS

In the group with positive screening, there is an apparent regulatory balance between the functions of the differentially expressed genes related to the pathogenesis of diabetes and a compensatory attempt to mitigate the possible etiology. These results support the 'two-step Carpenter-Coustan' strategy because pregnant women with negative screening do not need to continue on diagnostic investigation of gestational diabetes, thus reducing the cost of healthcare and the medicalization of pregnancy. Although not diabetic, they do have risk factors, and thus attention to these genes is important when considering disease evolution because this pregnant women are a step toward developing diabetes compared with women without these risk factors.

摘要

目的

评估未患糖尿病(妊娠期糖尿病(GDM)筛查阳性但诊断阴性)的孕妇全血细胞的基因表达谱,并与GDM筛查阴性的孕妇进行比较。

研究设计与方法

在圣保罗州立大学医学院博图卡图校区糖尿病围产期研究中心和博图卡图仁慈医院(UNIMED)招募孕妇。分为2组:对照组(n = 8),GDM筛查阴性且非糖尿病(ND,n = 13),GDM筛查阳性但诊断阴性。采集外周血样本进行血糖、糖化血红蛋白和微阵列基因表达分析。

结果

基因表达谱评估显示对照组和ND组之间存在显著差异,有22个差异表达的基因序列。生成基因网络和相互作用表以评估与感兴趣的差异表达基因相关的生物学过程。

结论

在筛查阳性组中,与糖尿病发病机制相关的差异表达基因的功能之间存在明显的调节平衡,并且有减轻可能病因的代偿性尝试。这些结果支持“两步Carpenter-Coustan”策略,因为筛查阴性的孕妇无需继续进行妊娠期糖尿病的诊断性检查,从而降低了医疗保健成本和妊娠的医疗化程度。尽管她们不是糖尿病患者,但确实存在危险因素,因此在考虑疾病演变时关注这些基因很重要,因为与没有这些危险因素的女性相比,这类孕妇向糖尿病发展迈进了一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7541/5073650/44689875455d/bmjdrc2016000273f01.jpg

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