Role of increased plasminogen activator inhibitor-1 and vitronectin in gestational diabetes mellitus

Ozgen, Levent; Ozgen, Gulten; Dincgez, Burcu; Bayram, Feyza

doi:10.1590/1806-9282.20230563

Acessibilidade / Reportar erro

Brasil

Revista da Associação Médica Brasileira

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Assoc. Med. Bras. 69 (9) • 2023 • https://doi.org/10.1590/1806-9282.20230563 copy

Role of increased plasminogen activator inhibitor-1 and vitronectin in gestational diabetes mellitus

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

The aim of this study was to analyze the second-trimester levels of vitronectin and plasminogen activator inhibitor-1 in gestational diabetes mellitus.

METHODS:

This study was conducted between September 2020 and December 2020 at the University of Health Sciences, Bursa Yuksek Ihtisas Research and Training Hospital, Department of Obstetrics and Gynecology. A total of 30 pregnant women with gestational diabetes mellitus and 60 healthy controls between 24 and 27/6 weeks of gestation were included. The inclusion criteria were as follows: being between 18 and 45 years old and 24–27/6 gestational weeks, having singleton pregnancy, diagnosed with gestational diabetes mellitus by using a two-step challenge test. The exclusion criteria of this study were as follows: chronic inflammatory or infectious disease, fasting blood glucose>126 mg/dL, intolerance to glucose tolerance testing, abnormal liver or kidney function tests, as well as pregnancy with pre-gestational diabetes history of adverse perinatal outcomes. Serum vitronectin and plasminogen activator inhibitor-1 levels were measured using the enzyme-linked immunosorbent assay method.

RESULTS:

Vitronectin and plasminogen activator inhibitor-1 levels were higher in the gestational diabetes mellitus group compared with controls [91.85 (23.08) vs. 80.10 (39.18) ng/mL, for vitronectin and 6.50 (1.05) vs. 4.35(1.0) ng/mL, for plasminogen activator inhibitor-1 (for both p<0.001)]. vitronectin >84.7 ng/mL was found to predict gestational diabetes mellitus with a sensitivity of 70% and specificity of 63.3%. Moreover, vitronectin had a significant positive correlation with fasting blood glucose (r=0.476, p<0.001), postprandial blood glucose (r=0.489, p<0.001), HbA1c (r=0.713, p<0.001), and plasminogen activator inhibitor-1 (r=0.586, p<0.001).

CONCLUSION:

This study revealed that second-trimester vitronectin and plasminogen activator inhibitor-1 are increased in gestational diabetes mellitus and vitronectin could be a candidate for the prediction of gestational diabetes mellitus.

KEYWORDS:
Biomarkers; Gestational diabetes mellitus; Second trimester

Variables	GDM group (n=30)	Control group (n=60)	p
Age (years)	30.46 (5.37)	28.45 (5.62)	0.107^a a Independent-samples t-test
Gravida (n)	2 (1.25)	2 (2)	0.291^b b Mann-Whitney U test
Parity (n)	1 (1.25)	1 (2)	0.993^b b Mann-Whitney U test
Body mass index (kg/m²)	26.97 (1.87)	26.39 (1.96)	0.107^a a Independent-samples t-test
Cesarean section (n, %)	14 (46.7%)	20 (33.3%)	0.219^c c Chi-square test
Gestational age at delivery (weeks)	37 (1.47)	38.18 (1.44)	<0.003 ^a a Independent-samples t-test
Birth weight (g)	3,200 (2,150–4,560)	3,165 (2,060–4,350)	0.840^b b Mann-Whitney U test
Polyhydramnios (n,%)	4 (13.3%)	5 (8.3%)	0.474^c c Chi-square test
Macrosomia (n, %)	4 (13.3%)	5 (8.3%)	0.474^c c Chi-square test
Apgar score first min	7 (1)	8 (2)	0.430^b b Mann-Whitney U test
Apgar score fifth min	9 (1)	9 (1)	0.682^b b Mann-Whitney U test
Apgar first min <7	4 (13.3%)	6 (10%)	0.726^d d Fisher's exact test. Statistically significant value is indicated in bold.
Apgar fifth min<7	2 (6.7%)	2 (3.3%)	0.598^d d Fisher's exact test. Statistically significant value is indicated in bold.
NICU admission (n, %)	15 (30%)	9 (15%)	0.058^c c Chi-square test
Neonatal sepsis (n, %)	3 (10%)	5 (8.3%)	1.000^d d Fisher's exact test. Statistically significant value is indicated in bold.
RDS (n, %)	8 (16%)	4 (6.7%)	0.183^c d Fisher's exact test. Statistically significant value is indicated in bold.
Adverse perinatal outcome (n, %)	10 (33.3%)	12 (20%)	0.165^c c Chi-square test

Variables	GDM group (n=30)	Control group (n=60)	p
Fasting glucose (mg/dL)	87 (15)	75 (13)	<0.001 ^b b Mann-Whitney U test.
Postprandial glucose (mg/dL)	165.5 (45.75)	112 (26)	<0.001 ^b b Mann-Whitney U test.
HbA1c (%)	6.1 (1.13)	5.5 (0.97)	<0.001 ^b b Mann-Whitney U test.
C-reactive protein (mg/L)	3.3 (1.43)	2.4 (1.28)	<0.001 ^b b Mann-Whitney U test.
Urea (mg/dL)	26.14 (7.39)	25.73 (7.29)	0.773^a a Independent samples t-test
Creatinine (mg/dL)	0.71 (0.2)	0.6 (0.2)	0.077^b b Mann-Whitney U test.
AST (IU/L)	18 (14.25)	17 (5.75)	0.406^b b Mann-Whitney U test.
ALT (IU/L)	16 (8.25)	13 (6)	0.151^b b Mann-Whitney U test.
Hemoglobin (g/dL)	10.99 (1.46)	10.82 (1.17)	0.468^a a Independent samples t-test
Hematocrit (%)	32.89 (4.47)	32.43 (2.88)	0.521^a a Independent samples t-test
Platelet count (10³/L)	238 (51.25)	209 (51.75)	0.024 ^b b Mann-Whitney U test.
Vn (ng/mL)	91.85 (23.08)	80.10 (39.18)	<0.001 ^b b Mann-Whitney U test.
PAI-1 (ng/mL)	6.50 (1.05)	4.35 (1.0)	<0.001 ^b b Mann-Whitney U test.

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] *Corresponding author: drgaslanozgen@yahoo.com.tr