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妊娠糖尿病患者的妊娠相关血浆蛋白A(PAPP-A)浓度会发生变化。

PAPP-A concentrations change in patients with gestational diabetes.

作者信息

Caliskan Raziye, Atis Alev, Aydin Yavuz, Acar Deniz, Kiyak Huseyin, Topbas Fitnat

机构信息

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.

出版信息

J Obstet Gynaecol. 2020 Feb;40(2):190-194. doi: 10.1080/01443615.2019.1615041. Epub 2019 Jul 23.

Abstract

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.

摘要

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。

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