Abstract
Objectives: Estimation of serum levels of interleukin (IL)-1β, Osteoprotegerin (OPG)
and YKL-40 early in pregnancy of normotensive normoglycemic 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-1) for age, body mass index (BMI), baseline
systolic (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-Oral 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-1β, YKL-40 and OPG levels
in women free and with these disorders. Serum levels of IL-1β 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 GHT 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-1β as the significant predictors for GHT, high BMI, DBP and serum
YKL-40 as early predictors 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 array of cytokines at the 1st ANV has a high
diagnostic value for the upcoming pregnancy-induced disorders single or combination
with higher predictive value than the reliance on clinical data.
Keywords: Pregnancy, Insulin resistance, Diabetes mellitus, Hypertension, Cytokines,
Early predictio |
