Haemostasis and Concentration of CytoadhesiveMolecules in Gestational Diabetes

Overview

Objective of study:
Assess interrelations between parameters of haemostasis, fibrinolysis, acutestage proteins and cytoadhesive molecules in gestational diabetes (GDM), which in susceptiblewomen is actively induced by insulin resistance.Methods: In 33 pregnant women where based on the glucose tolerance test (75 g glucose) GDM wasrevealed, repeatedly fibrinogen values were assessed (FBG 4.38 ± 0.98 g/l), the antithrombin IIIactivity (ATIII% 103.83 ± 14.9), t-PA Ag(4.82 ± 3.35 ng/ml), PAI-1 Ag (158.04 ± 57.7 ng/ml), D-dimer(234.99 ± 455.36 ng/ml), plasma proteins - orosomucoid (ORM 0.506 ± 0.14 g/l), C reactive protein(1.34 ± 0.96 g/l), transferrin (3.77 ± 0.79 g/l), prealbumin (1.86 ± 0.83 g/l) and alpha-2-macroglobulin(A2M 2.01 ± 0.62 g/l) and cytadhesive molecules s ICAM-1(230.8 ± 57.76 ng/ml) and s E-selectin (35.50± 16.55 ng/ml). These findings were compared with parameters of the glucose and lipid metabo-lism and some anthropometric data (BMI, weight increments during pregnancy and birth weightof the infant).Results: After statistical evaluation in GDM positive correlations of FBG and BMI were found (r =0.871, p = 0,007) and also with the weight increment during pregnancy (r = 0.934, p = 0,0007).Hyperfibrinogenaemia is however probably compensated in stabilized cases of GDM by a higherproduction of t-PA (FBG:t-PA Ag, r = 0.782, p = 0.003). In GDM a marginal positive correlationbetween the value of the „atheroindex“ and the infant’s length was found r = 0.744 p = 0.0547).s E-selectin levels in GDM correlated inversely with ATIII activity (r = -0.905, p = 0.0028).Conclusion: The higher body weight of pregnant women with GDM is probably associated witha higher risk of thrombophilia (elevated fibrinogen). If in pregnant women infection developswith release of inflammatory cytokines, inducing on the endothelium expression of E-selectin,deterioration of thrombophilia (due to a decline of ATIII) activity must be foreseen.This work was supported by the Grant Agency of the Ministry of Health of the Czech Republic -grant. No. 3310-4.

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