Circulating progranulin levels in women with gestational diabetes mellitus and healthy controls during and after pregnancy.
OBJECTIVE
Progranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the role of PGRN in gestational diabetes mellitus (GDM), which is regarded as a model for early type 2 diabetes.


METHODS
PGRN serum levels were measured in 90 pregnant women (45 GDM and 45 normal glucose tolerance (NGT)). In addition, PGRN was measured during a 2-h, 75 g oral glucose tolerance test in 20 pregnant women (ten GDM and ten NGT) and in 16 of them post partum (ten GDM and six NGT).


RESULTS
PGRN concentrations were significantly higher in pregnant women compared with post partum levels (536.79 ± 31.81 vs 241.53 ± 8.86, P<0.001). Multivariate regression analyses showed a strong positive correlation of PGRN with estrogen and progesterone. The insulinogenic index, a marker of early insulin secretion, displayed a positive correlation with PGRN, both during and after pregnancy (R=0.47, P=0.034; R=0.63, P=0.012). HbA1c and the oral glucose insulin sensitivity index showed significant post partum associations with PGRN (R=0.43, P=0.049; R=-0.65, P=0.009).


CONCLUSIONS
PGRN concentrations are markedly lower after pregnancy regardless of the gestational glucose tolerance state. PGRN levels per se do not discriminate between mild GDM and NGT in pregnant women. Therefore, the development of GDM appears to be due to impaired β-cell function that is not related to PGRN effect.
Department of Laboratory Medicine, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. jelena.todoric@meduniwien.ac.at
Jelena
J
Todoric
Ammon
A
Handisurya
Thomas
T
Perkmann
Bernhard
B
Knapp
Oswald
O
Wagner
Andrea
A
Tura
Giovanni
G
Pacini
Harald
H
Esterbauer
Alexandra
A
Kautzky-Willer
D000328:Adult; D019540:Area Under Curve; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005951:Glucose Tolerance Test; D006262:Health; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D049590:Postpartum Period / Q000097:blood* / Q000378:metabolism; D011247:Pregnancy / Q000097:blood* / Q000378:metabolism; D011262:Pregnancy Trimester, Second / Q000097:blood / Q000378:metabolism; D000077153:Progranulins; D012044:Regression Analysis; D012720:Severity of Illness Index
C492314:GRN protein, human; D036341:Intercellular Signaling Peptides and Proteins; D000077153:Progranulins