title: Circulating thrombomodulin levels and clinical correlates in pregnant diabetics.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Yale University, New Haven, Connecticut 06520-8063, USA.
authors.forename: U
authors.initials: U
authors.lastname: Magriples
authors.forename: C D
authors.initials: CD
authors.lastname: Hsu
authors.forename: D W
authors.initials: DW
authors.lastname: Chan
authors.forename: N
authors.initials: N
authors.lastname: Nickless
authors.forename: J A
authors.initials: JA
authors.lastname: Copel
mesh_terms: 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*
chemical_list: D006442:Glycated Hemoglobin; D018180:Thrombomodulin