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Licensed Unlicensed Requires Authentication Published by De Gruyter March 14, 2015

First trimester concentrations of the TTR-RBP4-retinol complex components as early markers of insulin-treated gestational diabetes mellitus

  • Arrigo Fruscalzo EMAIL logo , Ambrogio P. Londero , Lorenza Driul , Andrea Henze , Laura Tonutti , Maria Ceraudo , Giuseppe Zanotti , Rodolfo Berni , Florian J. Schweigert and Jens Raila

Abstract

Background: The objective of the study was to investigate the relationship between first trimester maternal serum levels of the TTR-RBP4-ROH complex components and the later insurgence of an altered glucose metabolism during pregnancy.

Methods: Retrospective case control study including 96 patients between the 12th and 14th week of gestation, 32 that developed gestational diabetes mellitus (GDM), respectively, 21 non-insulin-treated (dGDM) and 11 insulin-treated (iGDM), 20 large for gestational age fetuses (LGA) without GDM and 44 patients with normal outcome as control. Serum concentrations of RBP4 and TTR were assessed by ELISA; serum concentration of ROH by reverse-phase high performance liquid chromatography (rpHPLC). The molecular heterogeneity of TTR and RBP4 was analyzed after immunoprecipitation by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS).

Results: iGDM patients were characterized by reduced TTR, RBP4 and ROH compared to controls (respectively, iGDM vs. controls, mean±SD: TTR 3.96±0.89 μmol/L vs. 4.68±1.21 μmol/L, RBP4 1.13±0.25 μmol/L vs. 1.33±0.38 μmol/L and ROH 1.33±0.17 μmol/L vs. 1.62±0.29 μmol/L, p<0.05). TTR containing Gly10 in place of Cys10 was lower in the iGDM group (p<0.05) compared to controls. In the final logistic regression model ROH significantly predicted the diagnosis of iGDM (OR 0.93, 95% CI 0.87–0.98, p<0.05).

Conclusions: First trimester maternal serum ROH, RBP4 and TTR represent potential biomarkers associated with the development of iGDM.


Corresponding author: Arrigo Fruscalzo, St. Franziskus-Hospital, Hohenzollernring 72, 48145 Münster, Germany, Phone: +49 02 51 9353917, Fax: +49 02 51 9354072, E-mail:

Acknowledgments

The authors would like to thank the study participants and the whole staff collaborating to the study, particularly during the step of sample collection and storage (Clinic of Obstetrics and Gynecology and Department of Laboratory Medicine, Institute of Clinical Pathology, University of Udine, Italy), as well during the step of sample examination (Institute of Nutritional Science, University of Potsdam, Germany). We are also grateful to Prof. Diego Marchesoni, Prof. Francesco Curcio, and Dr. Giuliana Stel for their helpful suggestions.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Financial support: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2014-9-19
Accepted: 2015-2-10
Published Online: 2015-3-14
Published in Print: 2015-9-1

©2015 by De Gruyter

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