Objectives: Estimation of serum levels of interleukin (IL) 1 13, Osteoprotegerin (OPG) and YKL-40 early in pregnan cy of nonnotensive nonnoglycemic women to find early predictors for development of gestational Insulin resistance (GIR), hypertension (GHT) and/or diabetes mellitus (GDM).
Patients & Methods: The study included 255 pregnant women who were evaluated during their 1st antenatal visit (ANV-I) for age, body mass index (BMI), baseline sys tolic (SBP) and diastolic blood pressure (DBP) and gave blood samples for estimation of serum levels of insulin and the studied cytokines. Then, all women underwent 75-0ral glucose tolerance test (OGTT) for diagnosis of GDM and the homeostasis model assessment of IR (HOMA-IR) score at 6th and 24th GW.
Results: 32 women developed GIR that progressed to GDM, 38 women developed GHT, 13 developed GIR and GHT and 7 women developed the triad of GIR, GDM and GHT. There are significant differences in serum IL-113, YKL-40 and OPG levels m women free and with these dis orders. Semm levels of IL-113 showed positive, while serum OPG levels showed negative significant correlations with the incidence of pregnancy-induced disorders, while high serum YKL-40 was positively correlated with the incidence of GIR with GI--IT or GDM or both. ROC curve and Regression analyses defined combination of high DBP and serum YKL-40 as the significant early predictors for development of the three disorders, while high HOMA-IR score, SBP and serum IL-lß as the sigmficant predictors for GHT, high BMI, DBP and serum YKL-40 as early pre dictors for GIR and GHT and high serum YKL-40 and low serum OPG levels as early predictors for GIR and DM. Conclusion: Estimation of the studied an-ay of cytokines at the 1st ANV has a high diagnostic value for the upcoming pregnancy-induced disorders smgle or combination with higher predictive value than the reliance on clinical data. |
