Referral Center for Diabetes in Pregnancy, Ministry of Health Republic of Croatia, Clinical Department of Obstetrics and Gynecology, Zagreb University Hospital Center, Zagreb, Croatia,
Psychiatr Danub. 2021 Sep;33(Suppl 10):43-51.
In addition to its neuroprotective effect, Brain-derived neurotrophic factor (BDNF) also plays a role in glucose and lipid metabolism. This study aims: a) to find changes in the BDNF concentration during pregnancy in type 1 diabetes. b) to prove the effect of DHA and EPA supplementation on changes in BDNF concentrations c) to investigate the impact of hypoglycemia on BDNF concentration.
The data from this study were from the PRE-HYPO cohort study. Twenty-one of them were on a standard diabetic diet enriched with EPA and DHA (EPA 120 mg/day and DHA 616 mg/day; Exposed group), and nineteen pregnant diabetic women were on the standard diabetic diet without EPA and DHA supplementation (Non-exposed group). In the first trimester of pregnancy, fifteen pregnant women developed hypoglycemia episodes (≤3.9 mmol/L; HYPO+ group), and twenty-five pregnant women did not have hypoglycemia episodes (HYPO- group).
BDNF concentration significantly decreased during pregnancy from the first to the third trimester, in Non-exposed from 25.1 (22.0-30.2) to 22.1 (16.3-28.2), P<0.05, in the Exposed group from 22.1 (19.8-25.9) to 18.1 (14.8-18.9), P<0.01. Pregnant patients with hypoglycemia episodes (HYPO+ subgroup) had significantly higher BDNF in the third trimester of pregnancy [22.5 (20.6-28.4)] when compared with patients who did not develop hypoglycemia [16.3 (14.3-18.8), P<0.001]. In the third trimester of pregnancy, BDNF and n-6 PUFAs were associated with hypoglycemia (OR 1.818 95 % CI 1.079-3.003, P=0.025; OR 1.103 95 % CI 1.001-1.217, P=0.048). Total F.A.s were inversely associated with hypoglycemia (OR 0.969 95% CI 0.939-0.998, P=0.048).
Pregnant women with hypoglycemia (HYPO+ group) had higher concentrations of BDNF in the first and third trimesters of pregnancy compared to those without hypoglycemia. An increase in body weight during pregnancy leads to a decrease in BDNF concentration.
脑源性神经营养因子（BDNF）除了具有神经保护作用外，还在葡萄糖和脂质代谢中发挥作用。本研究旨在：a）在 1 型糖尿病中寻找妊娠期间 BDNF 浓度的变化。b）证明 DHA 和 EPA 补充对 BDNF 浓度变化的影响。c）研究低血糖对 BDNF 浓度的影响。
本研究的数据来自 PRE-HYPO 队列研究。其中 21 名患者接受富含 EPA 和 DHA 的标准糖尿病饮食（EPA 每天 120mg 和 DHA 每天 616mg；暴露组），19 名妊娠糖尿病妇女接受不含 EPA 和 DHA 补充的标准糖尿病饮食（非暴露组）。在妊娠的第一个三个月，15 名孕妇出现低血糖发作（≤3.9mmol/L；HYPO+ 组），25 名孕妇没有低血糖发作（HYPO- 组）。
BDNF 浓度在妊娠期间从第一个三个月到第三个三个月显著下降，非暴露组从 25.1（22.0-30.2）降至 22.1（16.3-28.2），P<0.05，暴露组从 22.1（19.8-25.9）降至 18.1（14.8-18.9），P<0.01。有低血糖发作（HYPO+亚组）的孕妇在妊娠第三个三个月的 BDNF 明显更高[22.5（20.6-28.4）]，而未发生低血糖的孕妇[16.3（14.3-18.8）]，P<0.001。在妊娠第三个三个月，BDNF 和 n-6PUFAs 与低血糖相关（OR 1.818，95%CI 1.079-3.003，P=0.025；OR 1.103，95%CI 1.001-1.217，P=0.048）。总脂肪酸与低血糖呈负相关（OR 0.969，95%CI 0.939-0.998，P=0.048）。
与无低血糖的孕妇相比，有低血糖（HYPO+组）的孕妇在妊娠的第一个和第三个三个月的 BDNF 浓度更高。怀孕期间体重增加会导致 BDNF 浓度降低。
