Identification of serum miR-1246 and miR-150-5p as novel diagnostic biomarkers for high-grade serous ovarian cancer

Epithelial ovarian cancer (EOC) is one of the leading cancers in women, with high-grade serous ovarian cancer (HGSOC) being the most common and lethal subtype of this disease. A vast majority of HGSOC are diagnosed at the late stage of the disease when the treatment and total recovery chances are low. Thus, there is an urgent need for novel, more sensitive and specific methods for early and routine HGSOC clinical diagnosis. In this study, we performed miRNA expression profiling using the NanoString miRNA assay in 34 serum samples from patients with HGSOC and 36 healthy women. We identified 13 miRNAs that were differentially expressed (DE). For additional exploration of expression patterns correlated with HGSOC, we performed weighted gene co-expression network analysis (WGCNA). As a result, we showed that the module most correlated with tumour size, nodule and metastasis contained 8 DE miRNAs. The panel including miR-1246 and miR-150-5p was identified as a signature that could discriminate HGSOC patients with AUCs of 0.98 and 1 for the training and test sets, respectively. Furthermore, the above two-miRNA panel had an AUC = 0.946 in the verification cohorts of RT-qPCR data and an AUC = 0.895 using external data from the GEO public database. Thus, the model we developed has the potential to markedly improve the diagnosis of ovarian cancer.

Influence of MiRNAs in gestational diabetes mellitus development

Gestational Diabetes Mellitus (GDM) is a metabolic disorder that is considered a prediabetes state. According to the International Diabetes Federation every year an increase in the number of women diagnosed with gestational diabetes is being noticed. It is known that GDM can cause many complications during pregnancy and labor. What is more, women with GDM history and their offspring are at risk of developing diabetes in the future. A new factor in the pathogenesis of GDM is epigenetics, which is described as changes in gene expression without directly modifying the DNA sequence. One of its regulating mechanisms is based on microRNA (miRNA). A small non-coding RNA sequence that has an influence on protein formation by suppressing gene expression. A better understanding of the miRNA's function could potentially lead to their usage as potential new biomarkers or treatment targets. In this article we review the most significant miRNA molecules in gestational diabetes.

A comparison of the International Association of Diabetes and Pregnancy Study Groups Recommendations with Former Criteria for Diagnosing Gestational Diabetes Mellitus: A Retrospective Cohort Study

AIM

The aim of the study was to compare the frequency of gestational diabetes mellitus (GDM) and pregnancy outcomes in women diagnosed by WHO 1999 and IADPSG criteria.

METHODS

This was a retrospective cohort study comprising 1508 women who underwent a 75-g OGTT after the 24th week of gestation at the University Hospital of Bialystok between 2004 and 2012.

RESULTS

GDM was diagnosed by WHO 1999 criteria in 486 (32.2%) patients and by IADPSG criteria in 397 (26.3%) women. Three hundred fifty five (23.5%) patients fulfilled both criteria, whereas 111 (7.4%) and 39 (2.6%) subjects met only WHO 1999 or IADPSG criteria, respectively. Isolated fasting hyperglycemia was found in 3.4% of patients fulfilling WHO 1999 criteria and in 17.6% of women who met IADPSG criteria. In total, fasting glycemic value was diagnostic in 42.8% of the participants fulfilling the new criteria. The main risk factor for GDM was family history of diabetes (OR 2.285 [95%CI: 1.772-2.945], p=0.00001). The rates of cesarean section and macrosomia were higher in the group with GDM than in the healthy women (54.7% vs 41.9% and 18.9% vs 13.9%, respectively), but the differences were not significant. Three months postpartum the disturbances of glucose tolerance were found in 21% of the patients with GDM.

CONCLUSIONS

The introduction of the IADPS criteria did not increase the prevalence of GDM, but increased the number of patients with fasting hyperglycemia. Twelve weeks postpartum the patients with prior GDM had significantly higher post-load glucose levels than the healthy women.

First-trimester irisin and fetuin-A concentration in predicting macrosomia

Objective: We investigated the diagnostic value of first-trimester adipokines and placental markers in predicting macrosomia. Methods: Out of 328 women recruited during the prenatal diagnosis between 11th and 13th week of pregnancy and subjected to follow up until delivery, we selected 26 women who gave birth to macrosomic babies and 34 women who gave birth to normal weight neonates for the evaluation of first trimester serum levels of pregnancy associated plasma protein-A, free β-human chorionic gonadotropin, placental growth factor (PIGF), and selected adipokines. Results: The mothers of macrosomic infants had higher PIGF (p = .049) and irisin concentrations (p = .00003), and lower fetuin-A levels (p = .0002) than had the mothers of normal weight babies. Newborn's weight correlated positively with maternal irisin (R = 0.454, p = .0003) and negatively with fetuin-A concentrations (R = -0.497, p = .00005). Multiple regression analysis showed that only serum irisin concentration was a significant predictor of birth weight (β = 0.329, p = .03), explaining 14% of its variability. The sensitivity and the specificity of irisin concentration in predicting macrosomia were 0.769 and 0.794, respectively (AUC = 0.818 [95%CI: 0.708-0.928], p = .00001) with a proposed cut-off value of 1725.4 ng/ml. Conclusions: Our results suggest that mother's irisin may be an early biomarker of macrosomia.

Serum irisin concentration in women with gestational diabetes

Irisin is a novel myokine and adipokine which induces an increase in total body energy expenditure, improving insulin sensitivity and glucose tolerance in experimental animals. In the present study, serum irisin concentration was measured by an enzyme immunoassay in 130 women with gestational diabetes mellitus (GDM) and 140 BMI-matched patients with normal glucose tolerance (NGT). Median irisin level was significantly lower in the patients with GDM than in the NGT subjects (1703.3 [1354.8-2097.9 ng/ml] versus 1873.8 [1519.8-2294.8 ng/ml], p = 0.01); however, 3 months after childbirth its concentrations did not differ markedly between the two groups (1165.9 [872.1-1497.5] ng/ml versus 1139.0 [984.0-1376.7] ng/ml). In the whole group, irisin concentration correlated negatively with 2 h glucose level (R = -0.14, p = 0.03). In the women with NGT, irisin concentration correlated positively with IS(OGTT) (R = 0.22, p = 0.04) and the disposition index (DI(120)) (R = 0.24, p = 0.03), as well as negatively with 2 h insulin level (R = -0.23, p = 0.03) and HOMA-IR (R = -0.24, p = 0.02). Multiple regression analysis revealed that 2 h glucose and DI(120) were the only variables significantly influencing serum irisin (β = 0.158, p = 0.03 and β = 0.159, p = 0.02, respectively). Our results suggest that serum irisin concentration increases markedly in pregnant women, but this increase seems to be significantly lower in patients with GDM.

Profiling of selected angiogenesis-related genes in proliferative eutopic endometrium of women with endometriosis

OBJECTIVE

To compare the expression level of the most relevant angiogenesis-related genes in the eutopic endometrium of women with and without endometriosis.

STUDY DESIGN

32 regularly menstruating patients (18 with endometriosis and 14 controls) underwent surgery in the proliferative phase of the cycle. Eutopic endometrium was collected by the use of aspirating biopsy prior to laparoscopy. Only patients with advanced (stage III and IV) histopathologically confirmed ovarian endometriosis were studied. Real-time PCR gene arrays were applied to examine the expression of 84 human angiogenesis-connected genes. Western-blot and enzyme-linked immunosorbent assays (ELISA) were used to confirm the expression of selected proteins.

RESULTS

We found significantly higher levels of AKT1 (p=0.003), TYMP (p=0.02), JAG1 (p=0.007), LAMA5 (p=0.005) and TIMP-1 (p=0.03) in eutopic endometrium of patients with endometriosis as compared with controls. By the use of Western blot we found clearly positive expression of AKT1 whereas ELISA assays confirmed expression of AKT1, TYMP, JAG1, LAMA5 and TIMP1.

CONCLUSION

Changes in the expression of selected genes might lead to or be a consequence of an early defect in the physiological activity of proliferative endometrium ultimately resulting in its overgrowth outside the uterine cavity.

MicroRNAs expression profiling of eutopic proliferative endometrium in women with ovarian endometriosis

BACKGROUND

The eutopic endometrium of women with endometriosis, compared with disease-free individuals, contains certain molecular alterations, including the differential expression of microRNA (miRNA). The aim of the study was to compare the expression of the most relevant miRNAs in the eutopic endometrium of women with and without ovarian endometriosis.

METHODS

A total of 46 regularly menstruating patients, 21 patients with ovarian endometriosis and 25 controls, underwent surgery in the proliferative phase of the cycle. The eutopic endometrium was collected through aspirating biopsy prior to laparoscopy. Only patients with advanced (stage III and IV) histopathologically confirmed ovarian endometriosis were included. TaqMan MicroRNA Array Cards were applied to examine the expression of 667 human miRNAs in 10 patients with endometriosis and 10 controls. Custom-made, low-density real-time PCR arrays were used to confirm the expression of 15 selected molecules in 21 endometriosis patients and 25 disease-free individuals.

RESULTS

Of 667 miRNAs, 2 were highly likely to be upregulated and 13 were downregulated in the eutopic endometrium of patients with endometriosis compared with the controls. Validation using real-time PCR showed that hsa-miR-483-5p (p = 0.012) and hsa-miR-629* (p = 0.02) are significantly downregulated in patients with endometriosis.

CONCLUSIONS

Changes in the expression of select miRNAs might lead to or be a consequence of an early defect in the physiological activity of the proliferative endometrium, ultimately resulting in the overgrowth of this tissue outside the uterus.

Determination of cathepsins B, D and G concentration in eutopic proliferative endometrium of women with endometriosis by the surface plasmon resonance imaging (SPRI) technique

OBJECTIVE

To determine the concentrations of cathepsins B, D and G in proliferative eutopic endometrium of patients with and without endometriosis, by use of the surface plasmon resonance imaging (SPRI) technique.

STUDY DESIGN

A total of 55 patients were recruited in the study: 31 patients with endometriosis (stages I-IV) and 24 controls. Endometrial samples were obtained in the first phase of the menstrual cycle from regularly menstruating premenopausal women, prior to laparoscopy, by the use of aspiration biopsy. Endometriosis was appropriately classified according to the Revised American Fertility Society classification and confirmed by histopathology in every case. The SPRI technique was used to determine the concentration of cathepsins B, D and G. To compare the two groups for quantitative data, Mann-Whitney-Wilcoxon's test was used due to the non-normal distribution of the tested variables and normality of distribution was assessed using Shapiro-Wilk W test.

RESULTS

The concentration of the three examined cathepsins was higher in the proliferative eutopic endometrium of patients with endometriosis, especially in advanced stages, e.g. III and IV, when compared to healthy individuals. Corresponding median values were, for cathepsin B: [7.93 pmol/mg (min-max 2.82-15.71) vs 1.2 pmol/mg (min-max 0.7-15.49) p=0.0014], for cathepsin D: [1.86 pmol/mg (min-max 0.51-5.4) vs 1.03 pmol/mg (min-max 0.4-2.72) p=0.00041] and for cathepsin G: [0.6 pmol/mg (min-max 0.33-2.51) vs 0.3 pmol/mg (min-max 0.16-1.29) p=0.00051].

CONCLUSIONS

Increased concentrations of cathepsins B, D and G in the proliferative eutopic endometrium may play a role in the implantation of endometrial tissue outside the uterine cavity.

The expression of genes involved in NF-κB activation in peripheral blood mononuclear cells of patients with gestational diabetes

OBJECTIVE

In patients with obesity and type 2 diabetes, the changes in insulin resistance are associated with the changes in expression of genes involved in nuclear factor-κB (NF-κB) activation in peripheral blood mononuclear cells (PBMCs). As such studies have never been carried out in patients with gestational diabetes (GDM), in this study, we evaluated the expression of genes involved in NF-κB activation and related to glucose metabolism in PBMCs obtained from pregnant women with GDM and normal glucose tolerance (NGT).

DESIGN AND METHODS

RT-PCR was performed in 60 pregnant women divided into three groups: GDM at the 1st visit, i.e. in the 24th-28th weeks of gestation (GDM1), NGT at the first visit and GDM in the 29th-32nd weeks (GDM2), and NGT at both visits. The tests were repeated 3 months postpartum.

RESULTS

The GDM1 group had significantly higher TLR2 (P=0.024), TLR4 (P=0.037), STAT1 (P=0.027), and CX3CL1 (P=0.017) mRNA expression, whereas the GDM2 group showed markedly lower TNFRSF1A (P=0.042), PPARG (P=0.018), STAT3 (P=0.013), and CX3CL1 (P=0.038) mRNA expression in comparison with the NGT group. The women with NGT at the 1st visit who later developed GDM had significantly higher fasting glucose (P=0.01), HOMA-IR (P=0.004), and TLR2 mRNA expression (P=0.04), as well as lower ISSI2 (P=0.01) and disposition indices, DI₃₀ (P=0.03) and DI₁₂₀ (P=0.01), than had the women who remained normoglycemic.

CONCLUSIONS

Our results suggest that elevated TLR2 expression, as well as higher fasting glucose and lower compensation for increased insulin resistance, may represent early metabolic disturbances in the development of GDM.

The expression of suppressor of cytokine signaling 1 and 3 in fat and placental tissue from women with gestational diabetes

The suppressor of cytokine signaling (SOCS) proteins are feedback inhibitors of signaling pathways induced by cytokines, hormones and growth factors. In the present study we measured the expression of SOCS1, SOCS3, interleukin-6 (IL-6), IL-6 receptor, IL-8 and leptin mRNA in paired samples of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and placental tissue obtained from 18 pregnant women with normal glucose tolerance (NGT) and 20 subjects with gestational diabetes mellitus (GDM), using quantitative RT-PCR. The patients with GDM had significantly higher IL-8 mRNA expression in VAT than the women with NGT (p = 0.007), whereas the expression of SOCS1, SOCS3 and other genes study did not differ significantly between the two groups. Stepwise regression analysis revealed that SOCS1 mRNA expression in VAT was significantly associated with prepregnancy BMI (β = -0.68, p = 0.03) and IL-8 mRNA expression (β = 0.66, p = 0.03), whereas SOCS3 mRNA expression in VAT was independently predicted by IL-6 mRNA expression (β = 0.94, p = 0.0002, R(2) = 0.88). In conclusion, our results did not show significant differences in SOCS1 and SOCS3 mRNA expression in adipose and placental tissue obtained from pregnant women with and without GDM.

Retinol-binding protein 4 in adipose and placental tissue of women with gestational diabetes

In the present study, we evaluated serum levels of retinol-binding protein 4 (RBP4) and the expression of RBP4, glucose transporter-4 (GLUT4) and peroxisome proliferator activated receptor gamma (PPARγ) mRNA (using quantitative real time-PCR) in subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and placental tissue obtained from patients with gestational diabetes (GDM) and healthy pregnant women. Serum RBP4 concentrations and its expression in SAT were higher in the women with GDM than in the controls (p = 0.03). No association between serum or tissue RBP4 and the indices of insulin resistance was noted. In the GDM group serum RBP4 correlated with its mRNA expression in SAT (r = 0.67, p = 0.007). Stepwise regression analysis revealed that RBP4 mRNA expression in SAT was independently predicted by GLUT4 mRNA expression (β= 0.59, p = 0.003) and the presence of GDM (β=0.46, p = 0.01), whereas RBP4 mRNA expression in VAT was related to PPARγ mRNA expression (β= 0.64, p = 0.0003) and the patient's age (β= -0.38, p = 0.03). In conclusion, our results suggest that the elevated expression of RBP4 in SAT may contribute to the increase in circulating RBP4 in GDM subjects.

The expression of transcription factor 7-like 2 (TCF7L2) in fat and placental tissue from women with gestational diabetes

In the present study we showed that the expression of transcription factor 7-like 2 (TCF7L2) mRNA in visceral adipose tissue obtained from 20 women with gestational diabetes was lower than in 18 pregnant women with normal glucose tolerance (p = 0.02), however after adjusting for BMI values, the difference was not significant.

Ghrelin in gestational diabetes: serum level and mRNA expression in fat and placental tissue

OBJECTIVES

We studied the effect of an oral glucose load on circulating ghrelin, as well as ghrelin and ghrelin receptor (GHS-R1a) mRNA expression in subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and placental tissue from pregnant women with gestational diabetes (GDM) and normal glucose tolerance (NGT).

METHODS

Plasma total ghrelin levels were measured in 58 patients with GDM and 61 women with NGT by radioimmunoassay. Ghrelin and GHS-R1a mRNA expression was studied in 16 subjects with GDM and 20 healthy pregnant women at term, using RT-PCR.

RESULTS

Basal ghrelin concentrations and the maximal decrease in ghrelin levels after glucose load did not differ in the women with GDM and NGT (399.1 [299.6-563.3] pg/ml vs. 400.9 [302.3-475.8] pg/ml and 127.6 [23.1-213.1] pg/ml vs. 101.7 [44.0-217.6] pg/ml, respectively). Ghrelin mRNA expression in placental tissue was significantly higher in the subjects with GDM than in the healthy pregnant women (0.06 [0.03-0.07] AU vs. 0.02 [0.015-0.03 AU], p=0.02), whereas GHS-R1a mRNA expression in all three tissues studied did not differ between the two groups. Multiple regression analysis revealed that ghrelin mRNA expression in SAT was significantly predicted by serum insulin (beta=0.62, p=0.01), explaining 42% of its variability.

CONCLUSIONS

Ghrelin mRNA expression in placental tissue was higher in the GDM than in NGT subjects, whereas no association between circulating ghrelin and GDM was observed.

Plasma apelin levels and apelin/APJ mRNA expression in patients with gestational diabetes mellitus

AIMS AND METHODS

Apelin is a novel adipokine identified as an endogenous ligand of the G protein-coupled receptor APJ. In this study we compared plasma apelin concentrations in 101 patients with gestational diabetes (GDM) and 101 women with normal glucose tolerance (NGT) between 24 and 32 weeks of gestation (Group 1), as well as in 20 women with GDM and 16 subjects with NGT at term (Group 2). Apelin and APJ mRNA expression in subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and placental tissue were also measured in Group 2, using quantitative real-time PCR.

RESULTS

There were no significant differences in plasma apelin levels between the women with GDM and NGT (Group 1: 1555.6 [1281.2-1804.2]pg/ml vs 1656.5 [1430.2-1852.1]pg/ml, Group 2: 1607.9 [1453.4-1768.7]pg/ml vs 1493.8 [1316.8-1956.7]pg/ml) nor in apelin and APJ mRNA expression in SAT, VAT and placental tissue. Apelin mRNA expression was approximately 10 fold higher in placental than in adipose tissue (p<0.0001). Apelin and APJ mRNA expression correlated significantly in SAT (R=0.45, p=0.03), VAT (R=0.69, p=0.003) and placental tissue (R=0.37, p=0.03).

CONCLUSIONS

No associations between circulating apelin or apelin/APJ mRNA expression and GDM or the indices of insulin resistance were noted in our study.

Circulating asymmetric dimethylarginine, endothelin-1 and cell adhesion molecules in women with gestational diabetes

We measured plasma concentrations of asymmetric dimethylarginine (ADMA), endothelin-1 (ET-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin in 56 patients with gestational diabetes (GDM), 68 pregnant women with normal glucose tolerance (NGT) and 36 healthy non-pregnant women. ADMA concentrations were markedly lower in NGT [0.48 (0.42-0.55) micromol/l] than in GDM subjects [0.50 (0.43-0.67) micromol/l] and healthy controls [0.57 (0.46-0.72) micromol/l, P = 0.005]. ET-1 levels were comparable between GDM [0.76 (0.58-0.90) pg/ml] and NGT women [0.75 (0.63-0.92) pg/ml] and significantly higher than in the non-pregnant subjects [0.62 (0.52-0.72) pg/ml, P = 0.007 and P = 0.005, respectively]. There were no differences in sVCAM-1 and E-selectin levels between the groups studied. ADMA levels were significantly associated with fasting glucose (beta = 0.23, P = 0.02) and gestational age (beta = 0.24, P = 0.01). Our results suggest that physiological adaptation to pregnancy is associated with a fall in circulating ADMA and an elevation of ET-1 concentrations, irrespective of the disturbances of glucose tolerance.

Visfatin in gestational diabetes: serum level and mRNA expression in fat and placental tissue

AIMS AND METHODS

In this study we measured: (1) serum visfatin concentrations in pregnant women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM) between 26 and 33 weeks of gestation, using two immunoassays: EIA and ELISA; (2) serum visfatin levels (ELISA) and its mRNA expression (quantitative real-time PCR) in subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and placental tissue from women with NGT and GDM at term.

RESULTS

Visfatin concentrations (measured by EIA and ELISA) did not differ in the women with GDM and NGT between 26 and 33 weeks of gestation but were significantly lower in GDM than in NGT subjects at term (2.7 [0.7-4.6] vs 5.2 [3.7-5.9]ng/ml, p=0.02). There was no difference in visfatin mRNA expression in fat and placental tissue between the two subgroups. Regression analysis revealed that visfatin mRNA expression was significantly related to interleukin-6 and tumour necrosis factor-alpha mRNA expression in SAT (beta=0.39, p=0.009 and beta=0.47, p=0.002) and placental tissue (beta=0.37, p=0.03 and beta=0.49, p=0.005).

CONCLUSIONS

Circulating visfatin was significantly lower in the GDM than in the NGT subjects at term, although no differences in its mRNA expression in fat and placental tissues were observed.

High resistin and interleukin-6 levels are associated with gestational diabetes mellitus

Resistin is a cysteine-rich adipokine originally described as a molecular link between obesity and insulin resistance in rodents. In this study, we hypothesised that serum resistin concentrations are elevated in patients with gestational diabetes mellitus (GDM) when compared with pregnant women with normal glucose tolerance (NGT) and related to proinflammatory interleukin-6 (IL-6) and other factors conferring insulin resistance. Serum resistin and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) in 81 women with GDM, 82 women with NGT between 24 and 31 weeks of gestation and 25 healthy non-pregnant women. Resistin concentrations were significantly higher in the GDM (21.9 [17.55-25.40] ng/ml) than in the NGT group (19.03 [15.92-23.91] ng/ml, p = 0.047), as well as in the non-pregnant women (14.8 [13.7-16.6] ng/ml, p < 0.0001). Serum IL-6 levels were elevated in the GDM (1.0 [0.7-1.5] pg/ml) as compared with the NGT group (0.8 [0.5-1.1] pg/ml, p = 0.006) and the non-pregnant controls (0.7 [0.5-1.1] pg/ml, p = 0.04). Multiple regression analysis revealed that in the pregnant women circulating resistin was related to serum IL-6 (beta = 0.33, p = 0.0004) but not to insulin or the index of insulin resistance. It is concluded that the finding of high resistin and IL-6 levels in women with gestational diabetes might confirm a role of low-grade inflammation in the pathogenesis of GDM.

Circulating pro- and anti-inflammatory cytokines in Polish women with gestational diabetes

In this study we measured serum concentrations of proinflammatory interleukin-6, interleukin-8, and interleukin-18 as well as anti-inflammatory interleukin-10 in 30 pregnant women with normal glucose tolerance, in 32 women with abnormal results of a 50-g glucose challenge test, and in 57 patients with gestational diabetes mellitus. Patients with gestational diabetes had significantly higher IL-6 (median 1.0 [0.7-1.5] vs. 0.7 [0.4-0.8] pg/ml, p=0.001), IL-8 (2.1 [1.1-4.2] pg/ml vs. 0.7 [0.4-0.9] pg/ml, p<0.0001), and IL-18 (249.3 [188.5-318.7] pg/ml vs. 186.7 [139.9-243.9] pg/ml, p=0.005) as well as lower IL-10 levels than healthy pregnant women (0.6 [0.5-1.5] pg/ml vs. 2.9 [1.8-3.2] pg/ml, p<0.0001). After adjusting for glucose, insulin, and BMI values, the differences in IL-8 and IL-18 became insignificant, whereas the differences in IL-6 and IL-10 levels remained highly significant (p<0.0001). The subjects with abnormal glucose challenge test results had higher IL-6 levels (0.9 [0.7-1.3] pg/ml, p=0.005) and similar levels of other cytokines as compared with the women with normal glucose tolerance. Our results suggest an impaired balance between circulating pro- and anti-inflammatory cytokines in patients with gestational diabetes; however, a significant contribution of maternal obesity to the increased levels of IL-8 and IL-18 should be underlined.

Circulating monocyte chemoattractant protein-1 in women with gestational diabetes

Monocyte chemoattractant protein 1 (MCP-1) has been implicated as a key factor in the recruitment and activation of peripheral blood leukocytes in atherosclerotic lesions and adipose tissue. Elevated levels of circulating MCP-1 have been found in patients with type 1 and type 2 diabetes, as well as with coronary artery disease. In this study we compared serum MCP-1 concentrations between pregnant women with normal glucose tolerance (NGT), gestational diabetes mellitus (GDM) and non-pregnant healthy women. The group studied consisted of 62 patients with GDM (mean age 30.1 +/- 5.0 years) at 29.0 +/- 3.5 week of gestation, 64 pregnant women with NGT (mean age 30.0 +/- 4.7 years) at 29.2 +/- 2.9 week of gestation and 34 non-pregnant healthy women (mean age 29.8 +/- 4.7 years). Serum MCP-1 concentration was measured using an enzyme - linked immunosorbent assay. Median MCP-1 concentrations did not differ significantly between women with GDM (median 342.3 [interquartile range 267.9-424.4] pg/ml) and NGT (338.0 [274.7-408.2] pg/ml), but were markedly lower than those found in non-pregnant women (485.2 [409.6-642.4] pg/ml, p<0.0001). After adjusting for glucose, the difference between pregnant and non-pregnant women remained highly significant (p<0.0001). In GDM patients MCP-1 levels correlated significantly with fasting glucose (r=0.2665, p=0.0363), insulin (r=0.4330, p=0.0004), HOMA-IR (r=0.4402, p=0.0003), ISQUICKI (r=-0.4402, p=0.0003), HbA1c (r=0.2724, p=0.0322), as well as with prepregnancy and current BMI (r=0.3501, p=0.0057 and r=0.3250, p=0.0106, respectively). Multiple regression analysis revealed that MCP1 concentrations were significantly predicted only by plasma glucose ( beta=0.3489, p=0.00004). Our results suggest that MCP1 levels are decreased in pregnant women, irrespective of their glucose tolerance status.