Asymmetric dimethylarginine level in hyperglycemic gestation

Area of Science:

• Reproductive Medicine
• Endocrinology
• Metabolic Disorders

Background:

• Carbohydrate intolerance during pregnancy, including gestational diabetes, poses risks to maternal and fetal health.
• Asymmetric dimethylarginine (ADMA) is a marker associated with endothelial dysfunction and metabolic alterations.
• Understanding ADMA's role in pregnancy-related carbohydrate intolerance is crucial for early detection and management.

Purpose of the Study:

• To investigate plasma ADMA concentrations in pregnant women with varying degrees of carbohydrate intolerance.
• To explore the relationship between ADMA levels and insulin sensitivity/resistance indices.
• To determine factors influencing ADMA levels in pregnant women with abnormal glucose metabolism.

Main Methods:

• A two-step approach involving a glucose challenge test (GCT) and oral glucose tolerance test (OGTT) was used for diagnosis.
• Plasma ADMA concentrations were measured in pregnant women with abnormal GCT (AGCT group), gestational diabetes (GDM group), and healthy controls.
• Insulin sensitivity/resistance indices (HOMA-IR, QUICKI, ISIOGTT) and glucose/insulin levels were evaluated.

Main Results:

• Both AGCT and GDM groups exhibited significantly higher plasma ADMA levels compared to controls.
• ADMA showed a moderate correlation with 2-hour post-OGTT insulin levels.
• The 2-hour insulin level during OGTT was identified as an independent predictor of ADMA concentration (R=0.57, P=0.0001).

Conclusions:

• Elevated plasma ADMA levels are associated with carbohydrate intolerance in pregnancy, even in cases of isolated abnormal GCT.
• Increased insulin levels, particularly 2-hour post-OGTT insulin, may contribute to higher ADMA concentrations in these conditions.
• ADMA may serve as a potential biomarker for monitoring metabolic changes in pregnant women with impaired glucose metabolism.