Serum levels of human placental lactogen, pregnancy‐associated plasma protein A and endometrial secretory protein PP14 in first trimester of diabetic pregnancy

Pedersen, Jan Fog; Søorensen, Steen; Mølsted‐Pedersen, Lars

doi:10.1034/j.1600-0412.1998.770204.x

Cited by 21 publications

(28 citation statements)

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“…19 Another study failed to detect this correlation in pregnant women with insulin-dependent DM. 17 Similarly, we identified no correlation between PAPP-A and HbA1c levels in women with GDM. These observations suggest that PAPP-A may not be useful for assessing or predicting glycaemic control in women with GDM due to the relatively short duration of women's exposure to GDM that is confined to the latter part of pregnancy.…”

Section: Discussionmentioning

confidence: 66%

“…[12][13][14] Several studies have shown that women with pre-existing diabetes mellitus (DM) have significantly lower PAPP-A levels than those without DM. 11,[15][16][17][18] Besides, PAPP-A levels in non-pregnant individuals with type 2 DM correlate inversely with glycosylated haemoglobin (HbA1c) levels. 19 These observations suggest that PAPP-A levels may reflect the degree of glycaemic control.…”

Section: Introductionmentioning

confidence: 99%

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Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

Wong

et al. 2015

Hong Kong Med J

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Introduction:Several studies have shown that women with pre-existing diabetes mellitus have significantly lower pregnancy-associated plasma protein-A levels than those without. This study aimed to evaluate whether first-trimester pregnancyassociated plasma protein-A multiple of median is associated with gestational diabetes mellitus in Chinese pregnant women. Methods:This prospectively collected case series was conducted in a regional hospital in Hong Kong. All consecutive Chinese women with a singleton pregnancy who attended the hospital for their first antenatal visit (before 14 weeks' gestation) from April to July 2014 were included. Pregnancyassociated plasma protein-A multiple of median was compared between the gestational diabetic (especially for early-onset gestational diabetes) and non-diabetic groups. The correlation between pregnancy-associated plasma protein-A level and glycosylated haemoglobin level in women with gestational diabetes was also examined. Results:Of the 520 women recruited, gestational diabetes was diagnosed in 169 (32.5%). Among them, 43 (25.4%) had an early diagnosis, and 167 (98.8%) with the disease were managed by diet alone. The gestational diabetic group did not differ significantly to the non-diabetic group in pregnancyassociated plasma protein-A (0.97 vs 0.99, P=0.40) or free β-human chorionic gonadotrophin multiple of median (1.05 vs 1.02, P=0.29). Compared with the non-gestational diabetic group, women with early diagnosis of gestational diabetes had a non- Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese womenNew knowledge added by this study • This is the first study to assess the association of first-trimester pregnancy-associated plasma protein-A multiple of median (PAPP-A MoM) with gestational diabetes mellitus (GDM) in a Chinese population. PAPP-A MoM was not predictive of development of non-insulin-dependent GDM in Chinese women.• There was no correlation between PAPP-A MoM and glycosylated haemoglobin level in Chinese women with GDM. PAPP-A levels were not useful to predict and identify poor glycaemic control in women with GDM.• There was a high prevalence of GDM (32.5%) in the Chinese population. Implications for clinical practice or policy • PAPP-A and β-human chorionic gonadotrophin do not seem to be predictive of non-insulin-dependent GDM.Other predictive model that comprises the maternal and clinical risk factors in Chinese women is warranted to identify women at risk of GDM.• Further studies that employ the new diagnostic criteria for GDM are warranted to examine the potential of first-trimester biochemical markers to predict GDM as well as their influence on the prevalence of GDM in the Chinese population.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

Wong

et al. 2015

Hong Kong Med J

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“…Some studies suggest IGF in 3 rd trimester was associated with macrosomia which others cannot substantiate [31]. With focus on timing of sampling, subsequent studies find high levels of IGF in 1 st trimester associated with early growth delay measured by ultrasound [32,33]. Inclusion of patients with various degrees of nephropathy precludes firm conclusion in pregnancy.…”

Section: Temporal Review Of Studies On Fetal Growth and The Igf Systemmentioning

confidence: 99%

“…A possible reduction in early fetal growth potential may be seen with low levels of IGFBP-3 proteolysis early in singleton diabetic pregnancy [32]. One study shows high levels of IGFBP-3 measured by RIA where one third of fetuses exhibit 'early growth delay' judged by ultrasound in first trimester [32]. In contrast levels of IGFBP-3 and IGFBP-3 protease activity increases in maternal serum in very early in multiple pregnancies [29].…”

Section: Maternal Compartmentmentioning

confidence: 99%

“…The appearance of several low molecular forms of IGFBPs confirms proteolysis of IGFBP as the mechanism behind the finding (Fig 3). A possible reduction in early fetal growth potential may be seen with low levels of IGFBP-3 proteolysis early in singleton diabetic pregnancy [32]. One study shows high levels of IGFBP-3 measured by RIA where one third of fetuses exhibit 'early growth delay' judged by ultrasound in first trimester [32].…”

Section: Maternal Compartmentmentioning

confidence: 99%

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Macrosomia and the IGF System: A Short Review

Al-Far¹,

Tjessem²,

Lauszus³

2017

Foc Sci

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Introduction: Macrosomia in diabetic pregnancy is an ubiquitous finding and implies both maternal and fetal issues. Its incidence surpasses other critical obstetrical morbidity in diabetic pregnancy with increased placental size and polyhydramnios as comorbidity. The studies on the underlying factors contributing to macrosomia have focused on growth stimuli like IGF, glycemia, and insulin and their effects on regional organ function. IGF-I and -II in maternal serum are associated with birth weight and the bioavailabiliy is modulated by IGF-binding-proteins (IGFBP) and phosporylated isoforms of IGFBP and the presence of proteases and IGF split products. Human placental growth hormone regulates the effect of IGF-I in pregnancy. Methods: The literature on the IGF system′s possible effect on fetal growth in diabetic pregnancy is reviewed before our current studies and updated with respect to later findings. Regulation on bioavailability by proteolysis and phosporylation is described. The review discusses briefly the studies on pregnant women with type 1 diabetes with respect to vasculopathy. Results: The data show good correlation of IGF-1/2 levels with birth weight. No such correlation with IGFBP-1 and -3 is found. Fetal growth deviation in diabetic pregnancy is not uniform. In first trimester, growth delay is documented in fetal growth curves compared to non-diabetic controls. Accordingly, a shift in IGF-IGFBP regulation in second trimester is found with less proteolysis of IGFBPs and relative increase in total binding capacity. In third trimester, free IGF further increases as IGFBP binding decreases by proteolysis and modulation. The first trimester values may be used as predictor of fetal weight at term. Diabetic women show a two-to threefold increase in the in vitro IGFBP-3 proteolytic activity during pregnancy as compared to post-partum values. Conclusions: Prominent proteolysis of binding proteins and the modulation by insulin account for the mechanism leading to macrosomia. The two factors combined guarantee the stimulation by more bioavailable IGF and the glycemic levels reveal whether insulin dose are optimal. Structural factors of diabetes i.e. microangiopathy further modulate the sum of effects on fetal growth. In contrast to macrosomia, fetal growth restriction is associated with prominent maternal vascular endothelial complications, such as overt nephropathy, proliferative retinopathy, preeclampsia, and hypertension. In parallel to the growth inhibition, stimulatory effects are exerted by the GH axis including the placental growth hormones and occur probably as compensatory mechanism, similar to the increased IGFBP-3 proteolysis in late pregnancy found in growth retardation. This influence may in part explain the disproportionate growth in different tissue components occurring in the various stages of diabetic pregnancy.

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The Placenta in a Diabetic Pregnancy

Hiden

Desoyé

2017

A Practical Manual of Diabetes in Pregnancy

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Serum levels of human placental lactogen, pregnancy‐associated plasma protein A and endometrial secretory protein PP14 in first trimester of diabetic pregnancy

Abstract: In first trimester of diabetic pregnancy there appears to be both a more general depression of trophoblast function, and also a specific depression of the hPL release.

Cited by 21 publications

References 11 publications

Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

Macrosomia and the IGF System: A Short Review

The Placenta in a Diabetic Pregnancy

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