3rd Department of Pediatrics, University General Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Department of Pathology, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Curr Vasc Pharmacol. 2023;21(4):234-245. doi: 10.2174/1570161121666230727150854.
Offspring exposed in foetal life to gestational diabetes mellitus (GDM) are at increased risk for future metabolic diseases.
To explore the prognostic role of abdominal aorta intima-media thickness (aIMT) in neonates exposed to GDM as a possible biomarker for later atherogenesis and its possible correlation with thioredoxin- interacting protein (TXNIP), a protein involved in oxidative stress.
In this prospective, observational study, mother-infant pairs were studied in 2 groups (57 patients with GDM and 51 controls without GDM). TXNIP levels were measured in the placenta, as well as in the umbilical and neonatal blood. The data were correlated with aIMT in neonates.
aIMT was increased in GDM offspring (patients: median [range]=0.39 mm [0.31-0.46] vs controls: median=0.28 mm [0.23-0.33]; p=0.001) and remained significant after adjusting for possible confounders (e.g., triglycerides, blood pressure, vitamin D, birth weight and gender; β coefficient=0.131 p=0.049). TXNIP levels were increased in trophoblasts (p=0.001) and syncytiotrophoblasts (p=0.001) and were decreased in endothelial cells (p=0.022) in GDM offspring vs controls. Moreover, TXNIP levels in trophoblasts positively correlated with aIMT (r=0.369; p=0.001). TXNIP levels in umbilical/ neonatal blood were not associated with GDM.
Increased aIMT was demonstrated in the offspring of mothers with GDM. Non-invasive measurement of aIMT could be used as a biomarker to identify children at increased risk for atherogenesis later in life. This information may encourage early preventive measures. TXNIP may be associated with GDM and/or aIMT.
在胎儿期暴露于妊娠期糖尿病（GDM）的后代患未来代谢性疾病的风险增加。
探讨腹主动脉内中膜厚度（aIMT）在 GDM 新生儿中的预后作用，作为动脉粥样硬化发生的潜在生物标志物，及其与硫氧还蛋白相互作用蛋白（TXNIP）的可能相关性，后者是一种参与氧化应激的蛋白。
在这项前瞻性观察性研究中，研究了 2 组母婴对（57 例 GDM 患者和 51 例无 GDM 对照组）。在胎盘以及脐血和新生儿血中测量了 TXNIP 水平。将这些数据与新生儿的 aIMT 相关联。
GDM 后代的 aIMT 增加（患者：中位数[范围]=0.39 毫米[0.31-0.46] vs 对照组：中位数=0.28 毫米[0.23-0.33]；p=0.001），且在调整了可能的混杂因素（例如甘油三酯、血压、维生素 D、出生体重和性别后仍然显著；β系数=0.131，p=0.049）。GDM 后代的滋养层（p=0.001）和合体滋养层（p=0.001）中的 TXNIP 水平升高，而内皮细胞中的 TXNIP 水平降低（p=0.022）。此外，滋养层中的 TXNIP 水平与 aIMT 呈正相关（r=0.369，p=0.001）。脐血/新生儿血中的 TXNIP 水平与 GDM 无关。
在患有 GDM 的母亲的后代中，发现 aIMT 增加。非侵入性测量 aIMT 可作为生物标志物，用于识别在未来生活中患动脉粥样硬化风险增加的儿童。这些信息可能会鼓励早期采取预防措施。TXNIP 可能与 GDM 和/或 aIMT 相关。
