Kurek Eken Meryem, Yayla Abide Cigdem, Sahin Ersoy Gulcin, Altun Ensari Tugba, Pekin Oya, Cevik Ozge
a Department of Obstetric and Gynecology, Adnan Menderes University School of Medicine , Aydin , Turkey.
b Zeynep Kamil Maternity /Children Education and Training Hospital , Istanbul , Turkey.
Gynecol Endocrinol. 2018 Jul;34(7):605-608. doi: 10.1080/09513590.2017.1420772. Epub 2017 Dec 28.
Gestational diabetes mellitus (GDM) is defined as glucose intolerance detected during pregnancy. GDM is increasing worldwide and is associated with adverse maternal and fetal outcomes. Neuregulin 4 (NGR4) is epidermal growth factor like signaling molecule. It plays an important role in cell to cell communication furthermore recent studies indicate that NRG4 may work as a novel adipokine with a possible role in maintaining energy and metabolic homeostasis. The aim of the present study was to assess serum NRG4 levels along with several metabolic parameters in patients diagnosed with gestational diabetic mellitus.
In this prospective cross-sectional study, the study group was composed of 63 women with GDM and 64 healthy pregnant women matched for age, body mass index (BMI) and gestational age. Blood samples were collected at the 24-28th gestational weeks. Serum NRG4, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides, glucose levels during 75-gr OGTT, fasting insulin, glycosylated hemoglobin A1c (HbA1c), alanine aminotransferase (ALT) and creatinine levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) values were calculated.
Serum NRG4 values were significantly elevated in the GDM group compared to the control group (p < .001). Multivariate linear regression analyzes revealed that BMI (β = 0.910, p < .001), glucose 2-h OGTT (β = 0.866, p < .001) and HOMA-IR (β = 0.222, p < .001) independently and positively predicted NRG4 levels.
Serum NRG4 levels were associated with metabolic parameters of GDM. The present study can be considered to be a guide for future studies to clarify the pathophysiology of NGR4 in GDM patients.
妊娠期糖尿病（GDM）被定义为孕期检测到的葡萄糖不耐受。GDM在全球范围内呈上升趋势，且与不良母婴结局相关。神经调节蛋白4（NGR4）是一种表皮生长因子样信号分子。它在细胞间通讯中发挥重要作用，此外，最近的研究表明，NRG4可能作为一种新型脂肪因子，在维持能量和代谢稳态方面可能发挥作用。本研究的目的是评估妊娠期糖尿病患者的血清NRG4水平以及多项代谢参数。
在这项前瞻性横断面研究中，研究组由63例GDM女性和64例年龄、体重指数（BMI）及孕周匹配的健康孕妇组成。在妊娠第24 - 28周采集血样。检测血清NRG4、总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯、75克口服葡萄糖耐量试验（OGTT）期间的血糖水平、空腹胰岛素、糖化血红蛋白A1c（HbA1c）、丙氨酸转氨酶（ALT）和肌酐水平。计算胰岛素抵抗的稳态模型评估（HOMA-IR）值。
与对照组相比，GDM组血清NRG4值显著升高（p < 0.001）。多变量线性回归分析显示，BMI（β = 0.910，p < 0.001）、2小时OGTT血糖（β = 0.866，p < 0.001）和HOMA-IR（β = 0.222，p < 0.001）独立且正向预测NRG4水平。
血清NRG4水平与GDM的代谢参数相关。本研究可被视为未来研究阐明NGR4在GDM患者病理生理学中的指导。
