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Serum osteocalcin concentrations in diabetic pregnant women and their newborns
M E Martinez1, P Catalan, A Lisbona
1Biochemistry Service La Paz Hospital, Universidad Autonoma, Madrid, Spain.
Insights
Maternal diabetes mellitus significantly reduces bone turnover in pregnant women and their infants. This study tracked osteocalcin and parathyroid hormone (PTH) levels, revealing decreased bone metabolism in diabetic pregnancies.
Area of Science:
- Endocrinology
- Obstetrics
- Bone Metabolism
Background:
- Pregnancy significantly alters bone metabolism, with hormonal changes affecting calcium homeostasis.
- Insulin-dependent diabetes mellitus (IDDM) may further impact these physiological adaptations during pregnancy.
- Understanding these effects is crucial for maternal and fetal health outcomes.
Purpose of the Study:
- To investigate the impact of insulin-dependent diabetes mellitus on maternal and fetal bone turnover markers throughout pregnancy and the perinatal period.
- To compare bone metabolism parameters in pregnant women with and without IDDM, as well as their neonates.
- To assess the influence of diabetes on serum levels of osteocalcin, parathyroid hormone (PTH), and calcitriol.
Main Methods:
- Serum levels of osteocalcin, PTH, and calcitriol were measured in 41 pregnant women with IDDM and 90 normal pregnant women across three trimesters.
- Measurements were repeated at delivery for 16 diabetic and 16 normal pregnant women, their infants' cord serum, and neonates.
- A control group of 48 non-pregnant women was included for comparison.
Main Results:
- Normal pregnant women showed increased PTH in the third trimester and calcitriol at delivery, with transiently decreased osteocalcin in the second trimester.
- Diabetic pregnant women exhibited stable PTH levels, lower osteocalcin throughout pregnancy compared to non-pregnant controls, and a smaller increase in calcitriol at delivery.
- Infants of diabetic mothers had lower PTH and osteocalcin levels than infants of normal mothers, while calcitriol levels were similar.
Conclusions:
- Insulin-dependent diabetes mellitus is associated with decreased bone turnover in pregnant women.
- This reduction in bone metabolism extends to the offspring during the perinatal period.
- Diabetes during pregnancy adversely affects maternal and fetal bone health.
Abstract:
Osteocalcin and PTH serum levels were measured in 41 insulin-dependent diabetic pregnant women through the three trimesters of pregnancy with a total of 106 determinations of osteocalcin and 137 of PTH. In parallel we quantified these parameters in 90 normal pregnant women throughout the three trimesters of pregnancy. In addition calcitriol, osteocalcin and PTH levels were quantified at delivery in 16 diabetic pregnant women and 16 normal pregnant women at delivery, in cord serum and in the infants during the first days of life. Non-pregnant women (n = 48) were the control group. In normal pregnant women PTH levels increased during the third trimester and total calcitriol increased at delivery. Osteocalcin levels decreased in the second trimester but returned to normal values during the third trimester of pregnancy. Diabetic pregnant women showed constant PTH levels throughout pregnancy. At delivery in diabetic pregnant women, total calcitriol levels increased to a smaller extent than in normal pregnant women. Osteocalcin concentrations in the second and third trimester of pregnancy were lower than in the non-pregnant group. Infants of diabetic mothers showed lower PTH and osteocalcin concentrations than infants of normal pregnant women, whereas their calcitriol levels were similar. These data indicate that diabetes decreases bone turnover during pregnancy in the mother and during the perinatal period in their offspring.