Longitudinal Assessment of Glycosylated Blood Protein Concentrations in Normal Pregnancy and Gestational Diabetes

Morris, Mary Ann; Grandis, Arnold S.; Litton, Jean C

doi:10.2337/diacare.9.2.107

Cited by 25 publications

(13 citation statements)

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“…In the abnormal group, the observed trend of mean HbAi levels was not so obvious, but a minimum level was still observed at 21-24 weeks while mean HbAi levels towards the last trimester were much higher than initial levels. This observed trend is similar to the results of other investigators [19][20][21].…”

Section: Discussionsupporting

confidence: 83%

Glycosylated Hemoglobins in Pregnant Women with Normal and Abnormal Glucose Tolerance

Loke

Chua²,

Kek³

et al. 1994

Gynecol Obstet Invest

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Glycosylated hemoglobin (HbA₁) levels were compared in low risk pregnant Singaporean women with normal and abnormal glucose response. HbA₁ (mean ± 1 SD) levels in normal and abnormal groups (489 and 72, respectively) were 4.65 ± 0.49 and 4.85 ± 0.50, respectively. While mean levels were significantly different, there was a considerable overlap of levels in both groups. At various gestation periods, mean HbAi levels between normal and abnormal groups showed significant difference only at late gestation. The latter may have contributed to significant differences in HbA₁ levels between normal and abnormal groups as a whole. The considerable overlap of HbA₁ values in normal and abnormal groups indicate that HbA₁ may be insensitive as a screening method for glucose intolerance.

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Section: Discussionsupporting

confidence: 83%

Glycosylated Hemoglobins in Pregnant Women with Normal and Abnormal Glucose Tolerance

Loke

Chua²,

Kek³

et al. 1994

Gynecol Obstet Invest

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“…Reproducibility of plasma glucose in OGTT may be difficult. The usage of the glycated proteins should obviate the need for depending on repeated OGTTs in these subjects (1).There has also been a tendency towards contradicting results of carbohydrate metabolism in pregnancy using GPP and GHb (9). While GHb values have been shown to decrease initially and then rise in late pregnancy, GPP levels were reported to exhibit a progressive fall in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…While some reports shows a steady decline GHb levels in pregnancy, others have reported an increase (9). Other indicators of medium glycaemia in pregnancy might therefore be desirable.…”

Section: Introductionmentioning

confidence: 99%

“…The controversy rests more on the response to a glucose or carbohydrate challenge in the various phases of pregnancy. Traditional tests on which these conclusions have been made were based on oral glucose tolerance test (OGTT), intravenous glucose tolerance test or casual blood glucose estimation (6)(7)(8)(9). OGTT, the gold standard of carbohydrate tolerance assessment has been shown to produce very erratic results in pregnancy as glucose absorption shows wide variations during pregnancy, making the results of OGTT poorly reproducible where changes are not gross.…”

Section: Introductionmentioning

confidence: 99%

“…GPP would reflect the lifespan of plasma proteins while GHb reflects the life span of the red cells (9)(10). The purpose of this cross-sectional study was therefore to determine the effect of pregnancy on medium carbohydrate metabolism using the levels of GPP and to assess whether medium carbohydrate metabolism in the African improves or deteriorates in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Medium-term carbohydrate tolerance improves and then deteriorates with advancing pregnancy in urban Nigerian women

Olorondu¹,

Ee²,

Ohwovoriole³

2010

Afr J Endocrinol Metab

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Background: It has been reported that carbohydrate metabolism does not deteriorate in pregnancy in the African, an observation at variance with general teaching. Objective: To determine the effect of pregnancy on medium term carbohydrate metabolism Methods: Medium term carbohydrate metabolism was evaluated in pregnant and non-pregnant Nigerian women using changes in Glycoted Plasma Proteins (GPP) as a surrogate for medium-term carbohydrate metabolism. Study subjects included women in all three trimesters of pregnancy, a group of non-pregnant women with normal carbohydrate metabolism and another group of women with confirmed diabetes already on treatment but not pregnant . Fasting plasma glucose was determined by the glucose oxidase method while GPP was determined using a modification of the thiobarbituric method with correction for levels of total plasma proteins (TPP). Average values are presented as mean (SD) while relationship between variables were determined using Pearson product moment correlation coefficients. Significance of p values of determinations is set at p <0.05. Results: Women in the various pregnancy trimesters were similar in age and without family or personal history of diabetes mellitus. Fasting plasma glucose (FPG) levels of pregnant women in all trimesters were lower than those of non-pregnant women of similar age. GPP values in the first and second trimesters were lower than non-pregnant women and third trimester pregnant women. GPP was highest in the third trimester of pregnancy even being significantly higher than in the non-pregnant women. Correlation between FPG and GPP was highest and significant in the third semester. Conclusion: FPG levels are poor reflections of the carbohydrate tolerance in pregnancy. Carbohydrate metabolism is enhanced in the first trimester and thereafter deteriorates throughout pregnancy. When using GPP to assess carbohydrate metabolism in pregnancy, correction should be made for the level of total plasma proteins. Carbohydrate metabolism in the African deteriorates with advancing pregnancy.

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Glycated Hemoglobin and Serum Proteins as Tools for Monitoring

Goldstein

Jabbour

Ahmed

2003

International Textbook of Diabetes Mellitus

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Technological advances have greatly improved our ability to monitor glycemic control in patients with diabetes. To this end, one of the most important clinical advances that has improved modern diabetes care is the recognition that glucose undergoes nonenzymatic chemical reactions with various proteins in the blood, including hemoglobin, in a manner that allows the estimation of an integrated value of the glucose excursions over a period of weeks to months, providing a useful window for glucose monitoring using the hemoglobin A 1c (HbA 1c ). The early 1980s also saw the emergence of a second group of tests, collectively called “fructosamine,” which were based on a determination of glycated serum proteins, especially albumin, and found to be useful for similar clinical purposes over a shorter time period (2–3 weeks) compared to the HbA 1c . There has also been growing interest in utilizing measurement of advanced glycosylation end products (AGEs) in serum and in tissues as laboratory correlates of some of the chronic tissue damage observed in patients with diabetes. In the present chapter, starting from a chemical description of the glycation reactions, we will present the pathophysiological background necessary for an understanding of the variety of tests now used for glycated hemoglobin and albumin determination and their interpretation in different clinical encounters. Finally, we will describe AGEs and their potential relationship to the chronic complications of diabetes.

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Longitudinal Assessment of Glycosylated Blood Protein Concentrations in Normal Pregnancy and Gestational Diabetes

Cited by 25 publications

References 0 publications

Glycosylated Hemoglobins in Pregnant Women with Normal and Abnormal Glucose Tolerance

Glycosylated Hemoglobins in Pregnant Women with Normal and Abnormal Glucose Tolerance

Medium-term carbohydrate tolerance improves and then deteriorates with advancing pregnancy in urban Nigerian women

Glycated Hemoglobin and Serum Proteins as Tools for Monitoring

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