ABSTRACT
Gestational diabetes mellitus (GDM) is a metabolically complex disease with major genetic determinants. GDM has been associated with insulin resistance and dysfunction of pancreatic beta cells, so the GDM candidate genes are those that encode proteins modulating the function and secretion of insulin, such as that for calpain 10 (CAPN10). This study aimed to assess whether single nucleotide polymorphism (SNP)-43, SNP-44, SNP-63, and the indel-19 variant, and specific haplotypes of the CAPN10 gene were associated with gestational diabetes mellitus. We studied 116 patients with gestational diabetes mellitus and 83 women with normal glucose tolerance. Measurements of anthropometric and biochemical parameters were performed. SNP-43, SNP-44, and SNP-63 were identified by polymerase chain reaction (PCR)-restriction fragment length polymorphisms, while the indel-19 variant was detected by TaqMan qPCR assays. The allele, genotype, and haplotype frequencies of the four variants did not differ significantly between women with gestational diabetes mellitus and controls. However, in women with gestational diabetes mellitus, glucose levels were significantly higher bearing the 3R/3R genotype than in carriers of the 3R/2R genotype of the indel-19 variant (p = 0.006). In conclusion, the 3R/3R genotype of the indel-19 variant of the CAPN-10 gene influenced increased glucose levels in these Mexican women with gestational diabetes mellitus.
Subject(s)
Calpain/genetics , Diabetes, Gestational/genetics , INDEL Mutation , Polymorphism, Single Nucleotide , Adolescent , Adult , Blood Glucose/analysis , Diabetes, Gestational/blood , Diabetes, Gestational/epidemiology , Female , Genetic Predisposition to Disease , Genetic Variation , Haplotypes , Humans , Mexico , Middle Aged , Pregnancy , Risk Factors , Young AdultABSTRACT
BACKGROUND: Bleeding is a significant cause of maternal mortality in the world. Obstetric hysterectomy increases maternal morbidity and mortality. OBJECTIVES: To describe a modified technique of cesarean-hysterectomy to limit bleeding during surgery in cases of placenta accreta and placenta previa, which consist of hypogastric artery ligation before the removal of the uterus. Another objective of this study is to compare maternal outcomes of patients undergoing this technique with the usual technique. PATIENTS AND METHOD: Comparative, longitudinal, closed stydy. We analyzed the records of 86 patients undergoing cesarean-hysterectomy surgery, from July 1, 2008 to July 31, 2009, were programmed 29 patients with the modified technique and 57 with the usual. The main outcomes analyzed were: estimated bleeding during surgery, number of packed red blood cells and plasma units transfused and hospital stay in intensive care. RESULTS: Bleeding during surgery, blood transfusion and admission to intensive care demand, and hospital stay were significantly lower in patients with the modified technique. Also there were fewer trans and postoperative complications in this group. CONCLUSIONS: The results of this study show that the modified technique of cesarean-hysterectomy derives significant reduction of maternal morbidity, less massive transfusions demand to manage intensive care units.
