Plasma lipoproteins and hormones in progestational and gestational diabetes

ABSTRACT

To demonstrate the changes of lipids, lipoproteins, apolipoproteins [Apos], and pregnancy related hormones at early and late stages of gestation in healthy women and to describe the effect of both pregestational [PGDM] and gestational diabetes [GMD] on these parameters, this study was carried out on 30 pregnant women [10 were known PGDM patients, 10 were GMD patients and 10 were healthy women who were considered control subjects]. FBG and HbA1-c were higher in all PGDM women than in control subjects, whereas in GDM patients glucose was within normal level. FFA level was higher on both PGDM and GDM patients than in control subjects during gestation. Total TGs, VLDL, and LDL increased within gestation in the 3 groups and although total cholesterol, VLDL, LDL and HDL cholesterol followed a similar trend, their rise was less marked. The increase in apolipoproteins A [ApoA] and ApoB with gestation was parallel to the changes in HDL and LDL cholesterol, respectively, with no difference between the three groups. Plasma levels of estradiol, progesterone, and prolactin increased sharply with gestation in the three groups, but the values of estradiol and prolactin at early and late gestation, were lower in PGDM patients, while progesterone levels were lower than controls in GDM women, only at late gestation. Because estrogens are known to increase VLDL production, and decrease hepatic lipase activity, so the decreased estradiol levels in the diabetic patients seems to prevent the marked rise of lipoproteins above the normal range. From this study, it is concluded that the development of a dyslipidemic condition in diabetic pregnancy depends on the balance between the metabolic control and the level of sex hormones