Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
J Matern Fetal Neonatal Med. 2023 Dec;36(2):2272010. doi: 10.1080/14767058.2023.2272010. Epub 2023 Oct 23.
In pregnancies complicated by maternal obesity and diabetes, a disruption in inflammatory mediators occurs, resulting in endothelial microvascular dysfunction, oxidative stress, tissue damage, and maternal and feto-neonatal complications. To outline this proinflammatory status, an innovative approach is represented by the measurement of proinflammatory cytokines. Among these biomarkers, B-cell-activating factor (BAFF) and platelet-activating factor (PAF) play a key role in metabolic regulation, immune response to infections, tissue homeostasis, and "food-related inflammation." The aim of the present study is to investigate the blood expression of BAFF and PAF in a cohort of pregnant women affected by obesity and diabetes compared with a control group of healthy pregnant women.
A prospective longitudinal cohort study has been conducted on pregnant women referred to Fondazione Policlinico Universitario Gemelli IRCCS in Rome. For each pregnant woman, a capillary sample was collected with a swab in three different consecutive evaluations carried out in the three trimesters of pregnancy.
A total of 77 pregnant women have been enrolled. No significant differences in BAFF and PAF levels were longitudinally observed between groups. Focusing on the exposed group, in the third trimester of pregnancy, both PAF and BAFF levels were lower than the basal time. Among the selected group of patients who developed Gestational Diabetes, only PAF values were longitudinally lower when compared to other groups. The multivariate analysis showed that BAFF levels were positively correlated with thyroid-stimulating hormone levels. No macrosomia, no shoulder dystocia, no major perineal lacerations at birth, and no intrauterine growth restriction were observed in the whole population.
This study supports the involvement of metabolic and proinflammatory biomarkers in the mechanisms related to pregnancy complications. Improving a good metabolic environment for obese and diabetic pregnant women could break the vicious cycle connecting inflammation, oxidative stress, and metabolic disorders.
在合并有母体肥胖和糖尿病的妊娠中，炎症介质发生紊乱，导致内皮微血管功能障碍、氧化应激、组织损伤以及母婴和胎新生儿并发症。为了概述这种促炎状态，一种创新的方法是测量促炎细胞因子。在这些生物标志物中，B 细胞激活因子（BAFF）和血小板激活因子（PAF）在代谢调节、对感染的免疫反应、组织稳态和“与食物相关的炎症”中发挥关键作用。本研究旨在调查肥胖和糖尿病孕妇与健康孕妇对照组相比，血液中 BAFF 和 PAF 的表达。
对罗马 Gemelli 大学医院基金会的孕妇进行了前瞻性纵向队列研究。对每位孕妇，在妊娠的三个连续阶段，用拭子在三个不同的连续评估中采集毛细血管样本。
共纳入 77 名孕妇。在三组妊娠中，各组间 BAFF 和 PAF 水平在纵向观察上均无显著差异。关注暴露组，在妊娠晚期，PAF 和 BAFF 水平均低于基础时间。在发生妊娠期糖尿病的选定组患者中，与其他组相比，PAF 值仅在纵向下降。多变量分析显示，BAFF 水平与促甲状腺激素水平呈正相关。在整个人群中，未观察到巨大儿、肩难产、严重会阴裂伤和宫内生长受限。
本研究支持代谢和促炎生物标志物参与与妊娠并发症相关的机制。改善肥胖和糖尿病孕妇的良好代谢环境可能打破将炎症、氧化应激和代谢紊乱联系在一起的恶性循环。
