Maternal and Fetal Resistin in Pre-gestational, Gestational and Non-Diabetic Pregnancies (Pages 20-27)
1UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland; 2Center for Experimental Medicine, Queen’s University Belfast, Belfast, UK
Abstract: Objective: To investigate possible differences in maternal and cord resistin between pregnancies affected by maternal gestational (GDM) and pre-gestational diabetes (PGDM) compared to non-diabetic pregnancies. Design: Prospective case control study. Setting: Tertiary level unit. Methods: Thirty-four women with PGDM (20 Type 1 diabetes and 14 Type 2 Diabetes) donated blood samples at 14, 20 and 36 weeks. Fourteen women with GDM donated blood samples at 36 weeks. Twelve control women in each trimester were matched on BMI to diabetic participants. Participants also consented for collection of matched cord samples after delivery. Resistin was measured by ELISA. Main Outcome Measures: Serum resistin, clinical measures (maternal age, parity, type of diabetes (non-diabetic, gestational diabetes, pre-gestational diabetes (type 1 diabetes (T1DM) or type 2 diabetes (T2DM)), maternal gylcaemia (HbA1c and fructosamine), gestation at delivery, method of delivery, and outcomes (birth weight, Apgars, cord pH, admission to neonatal intensive care (NICU), serum resistin concentration); comparison based on clinical group. Results: Maternal resistin was statistically significantly lower in T1DM compared to both non-diabetic and T2DM (maternal third trimester resistin in non-diabetic 37.5ng/ml (16-123), GDM 18.4 ng/ml (4.4-54.4), T2DM 40.5 ng/ml (5.7-109) and T1DM 3.7 ng/ml (1.7-10.6) (p<0.01); this difference held in cord samples. Conclusions: This is the first study investigating resistin in T1DM, T2DM and GDM maternal and cord blood. Despite the increase in insulin resistance with gestational diabetes and T2DM, there was no associated rise in maternal or cord resistin. The reduction in resistin in T1DM pregnancy may be protective as resistin also has a pro-inflammatory role.
Keywords: Resistin, diabetes, pregnancy.