Serum Inflammatory Markers and Preeclampsia in Type 1 Diabetes:A prospective study

OBJECTIVE Inflammation and endothelial dysfunction have been associated with the immunobiology of preeclampsia (PE), a significant cause of adverse pregnancy outcomes. The prevalence of PE is elevated several fold in the presence of maternal type 1 diabetes mellitus (T1DM). Although cross-sectional studies of pregnancies among women without diabetes have shown altered inflammatory markers in the presence of PE, longitudinal studies of diabetic women are lacking. In maternal serum samples, we examined the temporal associations of markers of inflammation with the subsequent development of PE in women with T1DM. RESEARCH DESIGN AND METHODS We conducted longitudinal analyses of serum C-reactive protein (CRP), adhesion molecules, and cytokines during the first (mean ± SD, 12.2 ± 1.9 weeks), second (21.6 ± 1.5 weeks), and third (31.5 ± 1.7 weeks) trimesters of pregnancy (visits 1-3, respectively). All study visits took place before the onset of PE. Covariates were BMI, HbA1c, age of onset, duration of diabetes, and mean arterial pressure. RESULTS In women with T1DM who developed PE versus those who remained normotensive, CRP tended to be higher at visits 1 (P = 0.07) and 2 (P = 0.06) and was significantly higher at visit 3 (P <0.05); soluble E-selectin and interferon-?-inducible protein-10 (IP-10) were significantly higher at visit 3; interleukin-1 receptor antagonist (IL-1ra) and eotaxin were higher and lower, respectively, at visit 2 (all P <0.05). These conclusions persisted following adjustment for covariates. CONCLUSIONS In pregnant women with T1DM, elevated CRP, soluble E-selectin, IL-1ra, and IP-10 and lower eotaxin were associated with subsequent PE. The role of inflammatory factors as markers and potential mechanisms of the high prevalence of PE in T1DM merits further investigation.

Plasma Lipoproteins and Preeclampsia in Women with Type 1 Diabetes: A Prospective Study

Context: In nondiabetic pregnancy, cross-sectional studies have shown associations between maternal dyslipidemia and preeclampsia (PE). In type 1 diabetes mellitus (T1DM), the prevalence of PE is increased 4-fold, but prospective associations with plasma lipoproteins are unknown.

Objectives: The aim of this study was to define lipoprotein-related markers and potential mechanisms for PE in T1DM.

Design and Settings: We conducted a multicenter prospective study in T1DM pregnancy.

Patients: We studied 118 T1DM women (26 developed PE, 92 remained normotensive). Subjects were studied at three visits before PE onset [12.2 1.9, 21.6 1.5, and 31.5 1.7 wk gestation (means SD)] and at term (37.6 2.0 wk). Nondiabetic normotensive pregnant women (n 21) were included for reference.

Main Outcome Measures: Conventional lipid profiles, lipoprotein subclasses [defined by size (nuclear magnetic resonance) and by apolipoprotein content], serum apolipoproteins (ApoAI, ApoB, and ApoCIII), and lipolysis (ApoCIII ratio) were measured in T1DM women with and without subsequent PE.

Results: In women with vs. without subsequent PE, at the first and/or second study visits: lowdensity lipoprotein (LDL)-cholesterol, particle concentrations of total LDL and large (but not small) LDL, serum ApoB, and ApoB:ApoAI ratio were all increased (P 0.05); peripheral lipoprotein lipolysis was decreased (P0.01). These early differences remained significant in covariate analysis (glycated hemoglobin, actual prandial status, gravidity, body mass index, and diabetes duration) but were not present at the third study visit. High-density lipoprotein and very low-density lipoprotein subclasses did not differ between groups before PE onset.

Conclusions: Early in pregnancy, increased cholesterol-rich lipoproteins and an index suggesting decreased peripheral lipolysis were associated with subsequent PE in T1DM women. Background maternal lipoprotein characteristics, perhaps masked by effects of late pregnancy, may influence PE risk.

Effect of post-weld heat-treatment on the oxide film and corrosion behaviour of laser-welded shape memory NiTi wires

Post-weld heat-treatment (PWHT) was applied to NiTi weldments to improve the corrosion behaviour by modifying the microstructure and surface composition. The surface oxide film on the weldments is principally TiO2, together with some Ti, TiO, and Ti2O3. The surface Ti/Ni ratio of the weldments after PWHT is increased. The oxide film formed in Hanks’ solution is thicker on the weldments after PWHT. The pitting resistance of the weldments is increased by PWHT. The galvanic effect in the weldments is very small. The weldment with PWHT at 350 °C shows the best corrosion resistance among other heat-treated weldments in this study.

Effect of postweld heat treatment on the microstructure and cyclic deformation behavior of laser-welded NiTi-shape memory wires

NiTi wires of 0.5 mm diameter were laser welded using a CW 100-W fiber laser in an argon shielding environment with or without postweld heat-treatment (PWHT). The microstructure and the phases present were studied by scanning-electron microscopy (SEM), transmission-electron microscopy (TEM), and X-ray diffractometry (XRD). The phase transformation behavior and the cyclic stress–strain behavior of the NiTi weldments were studied using differential scanning calorimetry (DSC) and cyclic tensile testing. TEM and XRD analyses reveal the presence of Ni4Ti3 particles after PWHT at or above 623 K (350 °C). In the cyclic tensile test, PWHT at 623 K (350 °C) improves the cyclic deformation behavior of the weldment by reducing the accumulated residual strain, whereas PWHT at 723 K (450 °C) provides no benefit to the cyclic deformation behavior. Welding also reduces the tensile strength and fracture elongation of NiTi wires, but the deterioration could be alleviated by PWHT.

Effects of process parameters upon the shape memory and pseudo-elastic behaviors of laser-welded NiTi thin foil

This article discusses the effects of laser welding parameters such as power, welding speed, and focus position on the weld bead profile, microstructure, pseudo-elasticity (PE), and shape memory effect (SME) of NiTi foil with thickness of 250 um using 100W CW fiber laser. The parameter settings to produce the NiTi welds for analysis in this article were chosen from a fractional factorial design to ensure the welds produced were free of any apparent defect. The welds obtained were mainly of cellular dendrites with grain sizes ranging from 2.5 to 4.8 um at the weld centerline. A small amount of Ni3Ti was found in the welds. The onset of transformation temperatures (As and Ms) of the NiTi welds shifted to the negative side as compared to the as-received NiTi alloy. Ultimate tensile stress of the NiTi welds was comparable to the as received NiTi alloy, but a little reduction in the pseudo-elastic property was noted. Full penetration welds with desirable weld bead profiles and mechanical properties were successfully obtained in this study.