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Published on: January 26, 2024
Early Gestational Blood Markers to Predict Preeclampsia Complicating Gestational Diabetes Mellitus
Yan Xie1, Wenni Zhou1, Xiang Tao2
1Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China.
Insights
Predicting preeclampsia (PE) in gestational diabetes mellitus (GDM) patients is crucial. Plasma protein analysis identified soluble transferrin receptor (sTfR), ceruloplasmin (CP), and apolipoprotein E (ApoE) as potential early screening markers for PE in GDM.
Area of Science:
- Obstetrics and Gynecology
- Proteomics
- Biomarker Discovery
Background:
- Gestational diabetes mellitus (GDM) and preeclampsia (PE) are common pregnancy complications.
- GDM patients face an elevated risk of developing PE.
- Current methods lack sensitive markers for predicting PE in GDM patients.
Purpose of the Study:
- To investigate plasma proteins for the prediction of PE in GDM patients.
- To identify potential biomarkers for early screening of PE in GDM.
Main Methods:
- A nested cohort study included PE, GDM, PE with GDM, and control pregnant women.
- Plasma proteomics was analyzed using liquid chromatography‒mass spectrometry/mass spectrometry (LC-MS/MS) between 12-20 weeks of gestational age.
- Potential markers (sTfR, CP, ApoE, ITPR1) were validated via enzyme-linked immunosorbent assays (ELISAs).
Main Results:
- Proteasome activation, pancreatic secretion, and fatty acid degradation were noted in GDM.
- Renin secretion, lysosome, and proteasome pathways involving iron transport and lipid metabolism were enriched in PE complicating GDM.
- Distinct proteomic profiles were observed for PE complicating GDM compared to PE alone.
Conclusions:
- PE complicating GDM may possess unique pathophysiological mechanisms.
- Plasma levels of sTfR, CP, and ApoE show promise for early clinical screening of PE in GDM patients.
Objective:
Gestational diabetes mellitus (GDM) and preeclampsia (PE) are common pregnancy complications that share some common risk factors. GDM patients are also at high risk for PE. There are no sensitive markers for prediction, especially for the occurrence of PE in GDM patients. This study investigated plasma proteins for the prediction of PE in GDM patients.
Methods:
A total of 10 PE, 10 GDM, and 5 PE complicated with GDM cases, as well as 10 pregnant controls without obvious complications, were included in the nested cohort. The proteomics in the plasma collected at 12-20 weeks of gestational age (GA) were analyzed by liquid chromatography‒mass spectrometry/mass spectrometry. Some potential markers, such as soluble transferrin receptor (sTfR), ceruloplasmin (CP), apolipoprotein E (ApoE) and inositol 1,4,5-trisphosphate receptor 1 (ITPR1), were validated using enzyme-linked immunosorbent assays.
Results:
Functional analysis of the plasma showed that proteasome activation, pancreatic secretion, and fatty acid degradation were activated in the GDM group, and renin secretion-, lysosome-, and proteasome pathways involving iron transport and lipid metabolism were enriched in the PE group, distinguishing PE complicating GDM.
Conclusion:
Through proteomics analysis of plasma in early pregnancy, PE complicating GDM may have a unique mechanism from that of PE alone. Plasma sTfR, CP and ApoE levels have potential clinical applications in early screening.
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