No abstract

Background: Gestational Diabetes Mellitus (GDM) is one of the most common medical complications of pregnancy. The untreated GDM affects both the baby and mother during gestation as well as presents the risk of subsequent type 2 diabetes in mothers and babies. Objective: To determine the effect of GDM on plasma proteomics as variable plasma proteins can be secreted by the cells at the pathological sites and can serve as a biomarker of the disease. Method: Blood samples were taken from 400 pregnant women at early second trimester and they were followed till early third trimester or until the development of GDM. All the pregnant females were sampled again in 3rd trimester. Overall 42 pregnant females developed GDM. These females were grouped as GDM I and GDM II, before and after the development of gestational diabetes, respectively. An equivalent number of pregnant women who did not develop GDM served as control I and control II in early second and third trimester, respectively. Blood samples from all the groups were subjected to 2D gel electrophoresis. Result : Nineteen protein spots were differently expressed between GDM and control groups, two spots were further confirmed by LC-MS/MS as Retinol binding protein A4 and Transthyretin. These two proteins were found to be up regulated in GDM group in early second trimester as well as early 3rd trimester. Conclusion : Transthyretin and Retinol binding protein 4 can be used as predictive plasma biomarkers of GDM that might help in the identification of at-risk pregnancies, hence, providing the best opportunity for early treatment in order to prevent the onset or progression of the disease.

Disturbances in hepatic and renal profile are well documented in diabetic patients. Antenatal pregnant women (n=300) selected for blood sampling during the early 2ndtrimester (14–18 weeks of gestation) including 176 pregnant women with positive family history of GDM and 124 women without any history of GDM. All the subjects were followed up to the early 3rd trimester (24-28 weeks of gestation) or until the onset of GDM for second sampling. Mean values of ALP, AST and GGT were significantly higher (p<0.05), however, mean albumin was found to be significantly lower in early 2ndtrimester in those patients who subsequently developed GDM. Levels of ALT, total protein, and total bilirubin did not show significant variations in comparable groups. Uric acid levels were found to be significant in those patients who developed GDM in late trimester but creatinine levels remained almost the same in both trimesters. Among 300 patients, 58 subjects developed GDM, however, in these established cases, 27% were having positive family history while 9% presented negative family history suggesting a stronger relationship of GDM with clinical/family history of pregnant women. The results of our study indicate that abnormal liver and kidney profile namely AST, ALP, GGT, albumin and uric acid may adversely affect insulin resistance and if not controlled and treated timely may cause GDM and lead to type 2 diabetes. However, ALT, serum bilirubin, total protein and creatinine appear to have no value in GDM prediction.