Methylglyoxal, Glycated Albumin, PAF, and TNF-α: Possible Inflammatory and Metabolic Biomarkers for Management of Gestational Diabetes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Subjects
2.2. Anthropometry
2.3. Dietary Intervention
2.4. Enzyme-Linked Immunosorbent Assay (ELISA)
2.5. Statistical Analysis
3. Results
Correlations
4. Discussion
- (1)
- After the diagnosis, the metabolic parameters of the women following the suggested diet substantially stabilized. The median values of fasting and postprandial glucose levels were normal both at T0 and after 12 weeks, while HbA1c showed a modest increase, but their values remained within the normal range. The same was observed for MGO and GA, which both showed a slight increase in their values but without any statistical significance. The only significant increase was observed in the triglycerides values, confirming the results already shown in literature [32,33]. Despite the stability of the standard glycemic parameters, this increase could reflect an obesogenic pathway [34] due to an inflammatory and metabolic effect on insulin resistance of PAF, TNF-alfa [35], MGO [36], and GA [37], that needs further investigation.
- (2)
- Maternal body weight increased after 12 weeks, while fat mass reduced. This result, also associated with a correct evaluation of the food diaries, suggests an excellent dietetic adherence and a positive effect of the dietary intervention on body composition.
- (3)
- Despite this metabolic stability, a significant increase of two inflammatory cytokines (PAF and TNF-α) was observed, corresponding to the proinflammatory conditions of gestational diabetes mellitus (GDM), acting even without metabolic impairment.
- (4)
- Despite normal HbA1c and fasting glycaemia levels, the metabolic biomarkers MGO and GA were significantly different compared with the general population. For MGO, this difference was evident since the time of diagnosis at around 26 weeks.
- (5)
- Some positive correlations were observed among inflammatory markers, metabolic parameters, and the anthropometric analysis. For example, a strict correlation between MGO and fetal overgrowth was evident, and a correlation between PAF, MGO, and the HOMA index was also observed.
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Anthropometric Data | Before Pregnancy | p | |
---|---|---|---|
Height (cm) | 163 (160–168) | - | |
Pre-gestational weight (kg) | 62.8 (55.6–69.6) | - | |
Pre-gestational BMI (kg/m2) | 23.3 (21.0–26.3) | - | |
At diagnosis | After 12 weeks of diet | ||
Weight (kg) | 71.0 (63.5–78.5) | 78.0 (64.6–82.8) | <0.001 |
Arm circumference (cm) | 29.0 (26.9–30.1) | 28.8 (28.0–31.3) | ns |
Wrist circumference (cm) | 15.0 (14.3–16.0) | 15 (14.3–16.0) | ns |
Waist circumference (cm) | 96.0 (87.5–100.0) | 104.0 (97.9–107.1) | <0.001 |
Bicipital skinfold (mm) | 9.0 (7.8–13.3) | 10.7 (7.2–12.8) | 0.05 |
Tricipital skinfold (mm) | 21.6 (18.0–28.7) | 20.1 (16.8–25.8) | 0.001 |
Subscapular skinfold (mm) | 18.40 (13.40–25.20) | 14.4 (12.3–24.0) | 0.02 |
Delivery and newborn details | |||
Gestational age at birth (weeks+days) | 39+5 (39+0–39+6) | - | |
Birth weight (g) | 3170 (3040–3460) | - | |
Birth weight centile | 41.5 (22.5–67.8) | - | |
APGAR 1’ | 9 (9–9) | - | |
APGAR 5’ | 10 (10–10) | - |
Metabolic Data | At Diagnosis | After 12 Weeks of Diet | p |
---|---|---|---|
Fasting blood glucose (mg/dL) | 85.4 (79.4–90.8) | 80.0 (73.0–90.0) | ns |
Post prandial blood glucose (mg/dL) | 94.4 (88.4–103.9) | 97.1 (92.7–100.7) | ns |
Glycated hemoglobin (mmol/mol) | 30.5 (28.8–32.0) | 33.0 (31.8–35.3) | <0.001 |
Insulin (μU/mL) | 9.3 (5.5–14.3) | 9.7 (7.4–15.3) | ns |
HOMA index | 1.54 (0.88–2.31) | 1.45 (0.70–2.30) | ns |
Cortisol at 08:00 (μg/dL) | 27.6 (21.1–30.9) | 27.0 (23.0–32.4) | ns |
Total cholesterol (mg/dL) | 258 (221–279) | 267 (232–301) | ns |
HDL cholesterol (mg/dL) | 79 (65–87) | 75 (66–87) | ns |
LDL cholesterol (mg/dL) | 142 (109–167) | 146 (114–164) | ns |
Triglycerides (mg/dL) | 185 (150–208) | 227 (221–282) | <0.001 |
CRP (mg/dL) | 0.42 (0.17–0.63) | 0.35 (0.23–0.60) | ns |
Creatinine (mg/dl) | 0.47 (0.42–0.62) | 0.56 (0.50–0.67) | ns |
Ferritin (ng/ml) | 18 (12–35) | 23 (16–32) | ns |
GDM Women | GDM Women | ||||
---|---|---|---|---|---|
General Population | At Diagnosis | p | After 12 Weeks of Diet | p | |
MGO (μg/mL) | 0.25 (0.19–0.28) | 0.64 (0.46–0.90) | <0.001 | 0.71 (0.47–0.93) | <0.001 |
GA (nmol/mL) | 0.95 (0.63–1.4) | 1.12 (0.74–1.76) | ns | 1.51 (0.88–2.03) | <0.001 |
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Piuri, G.; Basello, K.; Rossi, G.; Soldavini, C.M.; Duiella, S.; Privitera, G.; Spadafranca, A.; Costanzi, A.; Tognon, E.; Cappelletti, M.; et al. Methylglyoxal, Glycated Albumin, PAF, and TNF-α: Possible Inflammatory and Metabolic Biomarkers for Management of Gestational Diabetes. Nutrients 2020, 12, 479. https://doi.org/10.3390/nu12020479
Piuri G, Basello K, Rossi G, Soldavini CM, Duiella S, Privitera G, Spadafranca A, Costanzi A, Tognon E, Cappelletti M, et al. Methylglyoxal, Glycated Albumin, PAF, and TNF-α: Possible Inflammatory and Metabolic Biomarkers for Management of Gestational Diabetes. Nutrients. 2020; 12(2):479. https://doi.org/10.3390/nu12020479
Chicago/Turabian StylePiuri, Gabriele, Katia Basello, Gabriele Rossi, Chiara Maria Soldavini, Silvia Duiella, Giulia Privitera, Angela Spadafranca, Andrea Costanzi, Emiliana Tognon, Mattia Cappelletti, and et al. 2020. "Methylglyoxal, Glycated Albumin, PAF, and TNF-α: Possible Inflammatory and Metabolic Biomarkers for Management of Gestational Diabetes" Nutrients 12, no. 2: 479. https://doi.org/10.3390/nu12020479
APA StylePiuri, G., Basello, K., Rossi, G., Soldavini, C. M., Duiella, S., Privitera, G., Spadafranca, A., Costanzi, A., Tognon, E., Cappelletti, M., Corsetto, P. A., Rizzo, A. M., Speciani, A. F., & Ferrazzi, E. (2020). Methylglyoxal, Glycated Albumin, PAF, and TNF-α: Possible Inflammatory and Metabolic Biomarkers for Management of Gestational Diabetes. Nutrients, 12(2), 479. https://doi.org/10.3390/nu12020479