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循环生长分化因子-15与妊娠期糖尿病胎儿生长的关联

Association of Circulating GDF-15 with Fetal Growth in Gestational Diabetes.

作者信息

Filardi Tiziana, Bleve Enrico, Viggiani Valentina, Galoppi Paola, Rizzo Giuseppe, Gorini Stefania, Caprio Massimiliano, Angeloni Antonio, Morano Susanna, Anastasi Emanuela

机构信息

Department for the Promotion of Human Sciences and Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta, 247, 00166 Rome, Italy.

Department of Experimental Medicine, "Sapienza" University, Viale Regina Elena 324, 00161 Rome, Italy.

出版信息

J Clin Med. 2025 Apr 17;14(8):2764. doi: 10.3390/jcm14082764.

Abstract

: Growth differentiation factor-15 (GDF-15) is a component of the transforming growth factor beta (TGF-β) family that may act as regulator of inflammation. A possible protective role of GDF-15 against glucose alterations has been hypothesized. The aim of this pilot study was to evaluate the relationship between a circulating concentration of GDF-15 and metabolic/inflammatory parameters, as well as with adverse perinatal outcomes in patients with gestational diabetes mellitus (GDM). : Twenty-four ( = 24) patients with GDM and = 29 age-matched pregnant women with normal glucose tolerance (NGT) were recruited at the third trimester of gestation. Clinical and biochemical parameters were collected. Serum levels of GDF-15, small dense low density lipoprotein cholesterol (sdLDL), interleukin 6 (IL-6), a Soluble Urokinase Plasminogen Activator Receptor (su-PAR) were measured by an enzyme-linked immunosorbent assay kit. Fetal ultrasound parameters, maternal, delivery, and perinatal outcomes, were assessed. Serum GDF-15 did not differ between GDM and NGT ( = 0.286). However, in linear regression analysis, a significant negative association was observed between GDF-15 and fetal weight percentile at the third trimester, only in patients with GDM ( = 0.013), even after adjustment for age and pre-pregnancy BMI ( = 0.029). GDF-15 positively associated with IL-6, adjusting for pre-pregnancy BMI ( = 0.047). Pregnant women with adverse perinatal outcomes had higher levels of GDF-15 ( = 0.043). In the regression model, higher levels of GDF-15 were associated with an increased likelihood of adverse perinatal outcomes after adjustment for age and pre-pregnancy BMI ( = 0.044). : Besides its action as regulator of inflammation, GDF-15 might have a possible protective role against hyperglycemia-related excessive fetal growth in GDM. GDF-15 circulating levels might also be related to adverse perinatal outcomes.

摘要

生长分化因子-15(GDF-15)是转化生长因子β(TGF-β)家族的一个组成部分,可能作为炎症调节因子发挥作用。有人推测GDF-15对血糖改变可能具有保护作用。本初步研究的目的是评估妊娠糖尿病(GDM)患者循环中GDF-15浓度与代谢/炎症参数以及不良围产期结局之间的关系。:在妊娠晚期招募了24例GDM患者和29例年龄匹配的糖耐量正常(NGT)孕妇。收集临床和生化参数。采用酶联免疫吸附测定试剂盒测量血清GDF-15、小而密低密度脂蛋白胆固醇(sdLDL)、白细胞介素6(IL-6)、可溶性尿激酶型纤溶酶原激活剂受体(su-PAR)水平。评估胎儿超声参数、母亲情况、分娩及围产期结局。GDM组和NGT组的血清GDF-15无差异(P = 0.286)。然而,在线性回归分析中,仅在GDM患者中观察到GDF-15与妊娠晚期胎儿体重百分位数之间存在显著负相关(P = 0.013),即使在调整年龄和孕前BMI后也是如此(P = 0.029)。调整孕前BMI后,GDF-15与IL-6呈正相关(P = 0.047)。围产期结局不良的孕妇GDF-15水平较高(P = 0.043)。在回归模型中,调整年龄和孕前BMI后,较高水平的GDF-15与不良围产期结局的可能性增加相关(P = 0.044)。:除了作为炎症调节因子的作用外,GDF-15可能对GDM中与高血糖相关的胎儿过度生长具有保护作用。循环中的GDF-15水平也可能与不良围产期结局有关。

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