Urinary excretion of inositol phosphoglycan P-type in gestational diabetes mellitus.
OBJECTIVE
The mechanisms underlying insulin resistance during normal pregnancy, and its further exacerbation in pregnancies complicated by gestational diabetes mellitus (GDM), are generally unknown. Inositolphosphoglycan P-type (P-IPG), a putative second messenger of insulin, correlates with the degree of insulin resistance in diabetic subjects. An increase during normal pregnancy, in maternal and fetal compartments, has recently been reported.


METHODS
A cross-sectional study was carried out in 48 women with GDM and 23 healthy pregnant women. Urinary levels of P-IPG were assessed spectrophotometrically by the activation of pyruvate dehydrogenase phosphatase in urinary specimens and correlated with clinical parameters.


RESULTS
Urinary excretion of P-IPG was higher in GDM than in control women (312.1 +/- 151.0 vs. 210.6 +/- 82.7 nmol NADH/min/mg creatinine, P < 0.01) with values increasing throughout pregnancy in control subjects (r2 = 0.34, P < 0.01). P-IPG correlated with blood glucose levels (r(2) = 0.39, P < 0.01 for postprandial glycaemia and r2 = 0.18 P < 0.01 for mean glycaemia) and birthweight in the diabetic group (r2 = 0.14, P < 0.01).


CONCLUSIONS
Increased P-IPG urinary excretion occurs in GDM and positively correlates with blood glucose levels. P-IPG may play a role in maternal glycaemic control and, possibly, fetal growth in GDM.
Scioscia
M
M
Department of Immunology and Molecular Pathology, Molecular Medicine Unit, Royal Free and University College Medical School, London, UK. marcoscioscia@gmail.com
Kunjara
S
S
Gumaa
K
K
McLean
P
P
Rodeck
C H
CH
Rademacher
T W
TW
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007295:Inositol Phosphates / Q000652:urine*; D008131:London; D011134:Polysaccharides / Q000652:urine*; D011247:Pregnancy; D012307:Risk Factors
D001786:Blood Glucose; D007295:Inositol Phosphates; D011134:Polysaccharides; C028039:inositol phosphate glycan