Circulating thrombomodulin levels and clinical correlates in pregnant diabetics.
The object of this study was to investigate the relationship of thrombomodulin (TM) and glycosylated hemoglobin (HbA1C) in pregnant diabetics and to determine clinical correlates. We performed a prospective cohort study of 53 patients: 25 women with insulin-dependent diabetes (group 1) and 28 with gestational diabetes (group 2). Group 1 underwent monthly determinations of HbA1C and TM. Group 2 underwent determination at 36 weeks of gestation. There was a significant difference in HbA1C between groups 1 and 2 (p=0.0005), but there was no difference in TM. There was no correlation between TM and HbA1C. TM levels correlated positively with serum creatinine (r=0.46, p=0.002), proteinuria (r=0.48, p=0.007), and duration of diabetes (r=0.41, p=0.042). TM was significantly higher in diabetics of advanced White Classification (p=0.008). With good control, TM does not appear to be elevated in a diabetic pregnancy. TM may be a marker of endothelial damage that correlates more with duration of diabetes and renal disease than with HbA1C, which reflects short-term control.
Magriples
U
U
Department of Obstetrics and Gynecology, Yale University, New Haven, Connecticut 06520-8063, USA.
Hsu
C D
CD
Chan
D W
DW
Nickless
N
N
Copel
J A
JA
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood*; D011254:Pregnancy in Diabetics / Q000097:blood* / Q000150:complications; D011446:Prospective Studies; D018180:Thrombomodulin / Q000097:blood*
D006442:Glycated Hemoglobin; D018180:Thrombomodulin