Caliskan Raziye, Atis Alev, Aydin Yavuz, Acar Deniz, Kiyak Huseyin, Topbas Fitnat
Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Department of Feto-Maternal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
J Obstet Gynaecol. 2020 Feb;40(2):190-194. doi: 10.1080/01443615.2019.1615041. Epub 2019 Jul 23.
Our aim was to assess the relationship between gestational diabetes and glucose intolerance regarding maternal serum PAPP-A and free β-hCG concentrations in first trimester pregnancies. This study was conducted on 278 women between 18-45 years old with singleton pregnancies. The subjects were divided into four groups, according to their 50 and 100 g OGTT results. Group 1 was the Control Group, Group 2 with positive 50 g OGTT results, but negative 100 g, Group 3 had gestational diabetes after testing with 50 g OGTT (≥180 mg/dl) or with 100 g OGTT. Finally Group 4 was made of women with a one single high glucose level after testing with 100 g OGTT. These groups were analysed in terms of OGTT results. In the GDM group, serum PAPP-A concentrations were significantly lower when compared with the Control Group's ( = 0.015). There was either no significant differences regarding free β-hCG concentrations among the groups. GDM rate is 21.1%, the patients with GDM had significantly low concentrations of serum PAPP-A but their f β-hCG concentrations did not change. Our results are supported by several studies. However, we need greater numbered studies for exact results.IMPACT STATEMENT Pregnancy associated plasma protein A (PAPP-A) is produced by the placenta in pregnancy. PAPP-A cleaves insulin-like growth factor (IGF) binding proteins. It would appear to have a role in regulating IGF bioavailability in pregnancy. This is important as the IGF axis plays a critical role in fetal growth, and placental growth and function during pregnancy. Some studies have reported that PAPP-A levels were impaired among women who subsequently developed GDM. The patients with GDM had significantly low concentrations of serum PAPP-A but their free β-hCG levels did not change. By looking at PAPP-A concentrations, we can predict patients that will be gestational diabetic and take precautions to protect the babies health, such as their diet or exercise.
我们的目的是评估孕早期孕妇血清妊娠相关血浆蛋白-A(PAPP-A)和游离β-人绒毛膜促性腺激素(β-hCG)浓度与妊娠期糖尿病和糖耐量异常之间的关系。本研究对278名年龄在18至45岁之间的单胎妊娠女性进行。根据她们50克和100克口服葡萄糖耐量试验(OGTT)结果,将受试者分为四组。第1组为对照组,第2组50克OGTT结果为阳性,但100克OGTT结果为阴性,第3组经50克OGTT(≥180毫克/分升)或100克OGTT检测后患有妊娠期糖尿病。最后,第4组由100克OGTT检测后仅有一次高血糖水平的女性组成。对这些组进行了OGTT结果分析。在妊娠期糖尿病组中,与对照组相比,血清PAPP-A浓度显著降低(P=0.015)。各组之间游离β-hCG浓度没有显著差异。妊娠期糖尿病发生率为21.1%,妊娠期糖尿病患者血清PAPP-A浓度显著降低,但游离β-hCG浓度没有变化。我们的结果得到了多项研究的支持。然而,我们需要更多数量的研究以获得确切结果。影响声明 妊娠相关血浆蛋白A(PAPP-A)在妊娠期间由胎盘产生。PAPP-A可裂解胰岛素样生长因子(IGF)结合蛋白。它似乎在调节妊娠期间IGF的生物利用度方面发挥作用。这很重要,因为IGF轴在胎儿生长以及妊娠期间胎盘的生长和功能中起着关键作用。一些研究报告称,随后发生妊娠期糖尿病的女性中PAPP-A水平受损。妊娠期糖尿病患者血清PAPP-A浓度显著降低,但游离β-hCG水平没有变化。通过观察PAPP-A浓度,我们可以预测可能患妊娠期糖尿病的患者,并采取预防措施保护婴儿健康,如调整饮食或加强锻炼。