Clinical Value of Echo-Tracking in Gestational Diabetes Mellitus.

BACKGROUND: Vascular endothelial function plays an essential role in gestational diabetes mellitus (GDM) pathogenesis. Vascular elasticity is evaluated by the echo-tracking (ET) technique. In this study, we aimed to assess the clinical value of the ET technique in women with GDM and provide a basis for early evaluation and prevention of gestational diabetes. METHODS: Sixty-five patients with GDM and 65 gestational week-matched normal glucose tolerance pregnant women were enrolled in this study. The endothelial function parameters of pressure-strain elasticity coefficient (EP), the common carotid stiffness index (ß), arterial compliance (AC), single-point pulsed-wave velocity (PWVß), and augment index (AI) of bilateral common carotid arteries, were compared between the GDM and control groups by using ET technique. The correlations between plasma glucose levels and ET parameters were also analyzed. RESULTS: Our results indicated that EP, ß, PWVß, and AI were significantly higher in the GDM group (p<0.05), whereas AC was significantly lower in patients with GDM than in the control group (p<0.001). In addition, fasting plasma glucose and plasma glucose level after 2 h oral glucose tolerance test was correlated with ET parameters of EP, ß, PWVß, AI, and AC. CONCLUSIONS: The application of ET technology to gestational diabetes women could provide a basis for early evaluation and prevention of gestational diabetes. It would detect early and accurate signs of diabetes in pregnant women and provide a timely and reasonable clinical treatment plan to reduce and delay the occurrence of complications.

Vascular endothelial dysfunction in gestational diabetes mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) is a common pregnancy-related disorder that pregnant women without diabetes develop glucose tolerance during pregnancy. Endothelial dysfunction is the early event of vascular complications of diabetes. However, the role of endothelial dysfunction in GDM remains unknown. In this study, we hypothesize that there is a correlation between endothelial dysfunction and GDM indexes in the patients. METHODS: 96 GDM patients and 96 gestational week-matched healthy pregnancies with normal glucose tolerance were recruited in our study. The expressions of endothelial function markers, including nitride oxidase (NO) and endothelin-1 (ET-1), as well as flow-mediated dilatation (FMD), were measured. In addition, their correlation in GDM patients were also analyzed using Pearson's correlation analysis. RESULTS: GDM patients displayed decrease on FMD and serum NO levels with an increase on serum ET-1 secretion in comparison with normal glucose tolerance group. ROC analysis identified the predictive value of FMD, ET-1 and NO for GDM. Furthermore, endothelial dysfunction was correlated with both fasting plasma glucose and plasma glucose levels after 1 h or 2 h of oral glucose tolerance test in GDM patients. CONCLUSION: Our data indicated that endothelial dysfunction was associated with GDM, and these markers might serve as potential biomarkers for GDM.

Influence of one-day diabetes mellitus clinic management on blood glucose control and prognosis in patients with gestational diabetes mellitus.

OBJECTIVE: To explore the influence of the one-day diabetes mellitus (DM) clinic management model on blood glucose control and prognosis in patients with gestational diabetes mellitus (GDM). METHODS: A total of 930 patients diagnosed with GDM by oral glucose tolerance test screening at 24-28 weeks of gestation were selected from those who underwent outpatient prenatal checkups at our hospital and were randomly divided into one-day DM clinic group (n = 509) and control group (n = 421). A one-day DM clinic intervention was conducted in the one-day DM clinic group, and individualized dietary interventions and exercise instruction were given in the control group. RESULTS: The compliance rates of fasting blood glucose and two-hour postprandial blood glucose (2-h PPBG) were higher in the one-day DM clinic group than in the control group (p < .05). The compliance rates of the oral glucose tolerance test and insulin release test were higher in the one-day DM clinic group than in the control group (p < .05). There existed statistically significant differences in fasting blood glucose before delivery, together with the difference between fasting blood glucose at enrollment and before delivery and the difference between glycated hemoglobin at enrollment and before delivery (p < .05). CONCLUSION: The one-day diabetes mellitus clinic management model is more conducive to blood glucose control in patients with GDM and more conducive to the recovery of blood glucose and islet function in patients with GDM after delivery and to reduce the occurrence of adverse pregnancy outcomes.

Profiling maternal plasma microRNA expression in early pregnancy to predict gestational diabetes mellitus.

OBJECTIVE: To profile the differential expression of plasma miRNAs in gestational diabetes mellitus (GDM). METHODS: In a pilot study conducted at a tertiary hospital in China between 2010 and 2014, peripheral blood samples were collected from women at 16-19weeks of pregnancy. Pooled samples from 10 women who were subsequently diagnosed with GDM and from 10 healthy controls were used to construct two small RNA libraries. High-throughput sequencing was performed, and differentially expressed miRNAs were validated by quantitative real-time polymerase chain reaction (qRT-PCR), followed by target prediction, Gene Ontology analysis, and pathway identification. RESULTS: Sequencing revealed 32 miRNAs that were differentially expressed in GDM, including 12 miRNAs that were upregulated and 20 that were downregulated. Differential expression of five upregulated miRNAs (hsa-miR-16-5p, hsa-miR-17-5p, hsa-miR-19a-3p, hsa-miR-19b-3p, hsa-miR-20a-5p) was confirmed by qRT-PCR. Target prediction showed that the major targets of these miRNAs were associated with insulin resistance and abnormal pregnancies. CONCLUSION: The five miRNAs that were differentially expressed in GDM could serve as noninvasive biomarkers. The results also provide insights into the molecular mechanisms that underlie GDM, thereby contributing to the diagnosis and treatment of this disease.

miRNA in plasma exosome is stable under different storage conditions.

Exosomes are small membrane-bound vesicles secreted by most cell types. Exosomes contain various functional proteins, mRNAs and microRNAs (miRNAs) that could be used for diagnostic and therapeutic purposes. How we should store the samples before RNA isolation and whether those long term stored samples could be used for circulating RNA investigation because of RNase is unknown. The aim of the study was to determine the stability of circulating miRNA in exosomes and plasma. Exosomes were isolated from plasma samples by using ExoQuick Precipitation methods. RNA was extracted from exosomes and the corresponding plasma samples with a Qiagen miRNeasy Mini kit. The concentration of RNA was measured by a Qubit® RNA HS Assay Kit, and quantitative PCR was used for individual miRNA expression level detection. Results showed that exosomal miRNA showed extra stability under different storage conditions and no significant influence on plasma miRNA, except for short term storage at 4 °C. It is thus indicated that exosome miRNAs can be good biomarkers based on their stability under various storage conditions.