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Abstract
Objectives The aim of this pilot study was to determine the serum concentration of heparan sulfate, hyaluronan, chondroitin sulfate and syndecan-1 and if these serum concentrations can be used to identify women at 20 weeks' gestation who later develop gestational diabetes mellitus (GDM).
Design Nested case–control study from Auckland, New Zealand participants in the prospective cohort Screening for Pregnancy Endpoints study.
Setting Auckland, New Zealand.
Participants 20 pregnant women (70% European, 15% Indian, 10% Asian, 5% Pacific Islander) at 20 weeks' gestation without any hypertensive complications who developed GDM by existing New Zealand criteria defined as a fasting glucose ≥5.5 mmol/L and/or 2 hours ≥9.0 mmol/L after a 75 g Oral Glucose Tolerance Test. Women not meeting these criteria were excluded from this study. The patients with GDM were matched with 20 women who had uncomplicated pregnancies and negative screening for GDM and matched for ethnicity, maternal age and BMI.
Primary and secondary outcome measures The primary measures were the serum concentrations of syndecan-1, heparan sulfate, hyaluronan and chondroitin sulfate determined by quantitative ELISA. There were no secondary outcome measures.
Results Binary logistic regression was performed to determine if serum concentrations of endothelial glycocalyx layer constituents in women at 20 weeks' gestation would be useful in predicting the subsequent diagnosis of GDM. The model was not statistically significant χ2=12.5, df=8, p=0.13, which indicates that the model was unable to distinguish between pregnant women at 20 weeks' gestation who later developed GDM and those who did not.
Conclusions Serum concentrations of syndecan-1, heparan sulfate, hyaluronan and chondroitin sulfate in pregnant women at 20 weeks' gestation were not associated with later development of GDM. To further explore whether there is any relationship between endothelial glycocalyx constituents and GDM, the next step is to evaluate serum concentrations at the time diagnosis of GDM.
- gestational diabetes mellitus
- glycocalyx
- glycosaminoglycans
- endothelium
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Footnotes
Contributors DSL, RST and LMEM designed the study. WH performed the ELISA assays. DSL performed the statistical analysis and drafted the manuscript. All authors were involved in the interpretation of data and critical revision of the manuscript. DSL (manuscript's guarantor) affirms that the manuscript is an honest and accurate account of the study and no aspects of the study have been omitted.
Funding This work was supported by the Performance-Based Research Fund of the Auckland Bioengineering Institute (DSL), the Department of Engineering Science (DSL), the New Enterprise Research Fund, Foundation for Research Science and Technology; Health Research Council 04/198; Evelyn Bond Fund, Auckland District Health Board Charitable Trust and the Nurture Foundation. The funders had no role in the study design; collection, analysis and interpretation of data; or preparation of this manuscript.
Competing interests None declared.
Patient Consent Obtained.
Ethics approval Ethical approval for the SCOPE Study was obtained from the New Zealand Health and Disability Ethics/Northern A Health and Disability Ethics Committees (20 Aitken Street, Wellington, New Zealand) (number AKX/02/00/364).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Extra data can be accessed via the Dryad data repository at http://datadryad.org/ with the doi:10.5061/dryad.5h2s7.