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Increased maternal bone formation in type I diabetic pregnancies
1Academic Obstetrics & Gynaecology, Imperial College School of Medicine at Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
Calcified Tissue International
|August 12, 1999
Summary
Maternal type I diabetes, or insulin-dependent diabetes, is linked to increased bone formation during pregnancy. This study found higher levels of a bone formation marker in diabetic mothers, suggesting a potential impact on fetal bone development.
Area of Science:
- Endocrinology
- Obstetrics
- Bone Metabolism
Background:
- Infants of mothers with insulin-dependent diabetes mellitus (IDDM) exhibit increased intrauterine bone resorption and reduced bone mineral content at birth.
- Pregnancy can influence maternal bone metabolism, but the specific effects of IDDM on maternal bone turnover are not fully understood.
Purpose of the Study:
- To investigate whether type I diabetes is associated with abnormal maternal bone metabolism during pregnancy.
- To assess bone formation and degradation rates in pregnant women with type I diabetes compared to healthy controls.
Main Methods:
- A case-control study involving 19 pregnant women with type I diabetes and 19 healthy pregnant controls in their third trimester.
- Measurement of circulating levels of carboxyterminal propeptide of type I procollagen (PICP) as a marker of bone formation.
- Measurement of cross-linked carboxyterminal telopeptide of type I collagen (ICTP) as a marker of bone degradation.
- Assessment of diabetic control using hemoglobin A1c levels (mean < 8.5% indicated good control).
Main Results:
- Circulating PICP levels were significantly higher in pregnant women with type I diabetes (median 147 µg/L) compared to controls (median 115 µg/L; P = 0.0014).
- No significant difference was observed in circulating ICTP levels between the type I diabetes group (median 4.6 µg/L) and the control group (median 4.6 µg/L; P = 0.907).
Conclusions:
- Pregnant women with type I diabetes exhibit an increased rate of bone formation.
- This increased bone formation may be influenced by higher insulin doses and improved glycemic control often achieved during pregnancy in women with IDDM.
- Further research is needed to understand the clinical implications of altered maternal bone metabolism in diabetic pregnancies on both mother and fetus.