Anti-angiogenic factors and pre-eclampsia in type 1 diabetic women
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01/01/2009
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Resumo |
Aims/hypothesis: Elevated anti-angiogenic factors such as soluble fms-like tyrosine kinase 1 (sFlt1), a soluble form of vascular endothelial growth factor receptor, and endoglin, a co-receptor for TGFß1, confer high risk of pre-eclampsia in healthy pregnant women. In this multicentre prospective study, we determined levels of these and related factors in pregnant women with type 1 diabetes, a condition associated with a fourfold increase in pre-eclampsia.<br/>Methods: Maternal serum sFlt1, endoglin, placental growth factor (PlGF) and pigment epithelial derived factor were measured in 151 type 1 diabetic and 24 healthy non-diabetic women at each trimester and at term.<br/>Results: Approximately 22% of the diabetic women developed pre-eclampsia, primarily after their third trimester visit. In women with pre-eclampsia (diabetic pre-eclampsia, n?=?26) vs those without hypertensive complications (diabetic normotensive, n?=?95), significant changes in angiogenic factors were observed, predominantly in the early third trimester and prior to clinical manifestation of pre-eclampsia. Serum sFlt1 levels were increased approximately twofold in type 1 diabetic pre-eclampsia vs type 1 diabetic normotensive women at the third trimester visit (p?<?0.05) and the normal rise of PlGF during pregnancy was blunted (p?<?0.05). Among type 1 diabetic women, third trimester sFlt1 and PlGF were inversely related (r2?=?42%, p?<?0.0001). Endoglin levels were increased significantly in the diabetic group as a whole vs the non-diabetic group (p?<?0.0001).<br/>Conclusions/interpretation: Higher sFlt1 levels, a blunted PlGF rise and an elevated sFlt1/PlGF ratio are predictive of pre-eclampsia in pregnant women with type 1 diabetes. Elevated endoglin levels in women with type 1 diabetes may confer a predisposition to pre-eclampsia and may contribute to the high incidence of pre-eclampsia in this patient group. |
Identificador | |
Idioma(s) |
eng |
Direitos |
info:eu-repo/semantics/restrictedAccess |
Fonte |
Yu , Y , Jenkins , A J , Nankervis , A J , Hanssen , K F , Scholz , H , Henriksen , T , Lorentzen , B , Clausen , T , Garg , S K , Menard , M K , Hammad , S M , Scardo , J C , Stanley , J R , Dashti , A , May , K , Lu , K , Aston , C E , Wang , J J , Zhang , S X , Ma , J-X & Lyons , T J 2009 , ' Anti-angiogenic factors and pre-eclampsia in type 1 diabetic women ' Diabetologia , vol 52 , no. 1 , pp. 160-168 . DOI: 10.1007/s00125-008-1182-x |
Palavras-Chave | #Hemoglobin A, Glycosylated #Pregnancy Complications #Humans #Vascular Endothelial Growth Factor Receptor-1 #Pre-Eclampsia #Nerve Growth Factors #Receptors, Cell Surface #Angiogenesis Inhibitors #Membrane Proteins #Pregnancy #Eye Proteins #Diabetes Mellitus, Type 1 #Antigens, CD #Serpins #Adult #Female #Growth Hormone |
Tipo |
article |