title: Haptoglobin phenotype, pre-eclampsia, and response to supplementation with vitamins C and E in pregnant women with type-1 diabetes.
abstract: OBJECTIVE
  The phenotype of the antioxidant and pro-angiogenic protein haptoglobin (Hp) predicts cardiovascular disease risk and treatment response to antioxidant vitamins in individuals with diabetes. Our objective was to determine whether Hp phenotype influences pre-eclampsia risk, or the efficacy of vitamins C and E in preventing pre-eclampsia, in women with type-1 diabetes.
  
  
  METHODS
  This is a secondary analysis of a randomised controlled trial in which women with diabetes received daily vitamins C and E, or placebo, from 8 to 22 weeks of gestation until delivery.
  
  
  METHODS
  Twenty-five antenatal metabolic clinics across the UK (in north-west England, Scotland, and Northern Ireland).
  
  
  METHODS
  Pregnant women with type-1 diabetes.
  
  
  METHODS
  Hp phenotype was determined in white women who completed the study and had plasma samples available (n = 685).
  
  
  METHODS
  Pre-eclampsia.
  
  
  RESULTS
  Compared with Hp 2-1, Hp 1-1 (OR 0.59, 95% CI 0.30-1.16) and Hp 2-2 (OR 0.93, 95% CI 0.60-1.45) were not associated with significantly decreased pre-eclampsia risk after adjusting for treatment group and HbA1c at randomisation. Our study was not powered to detect an interaction between Hp phenotype and treatment response; however, our preliminary analysis suggests that vitamins C and E did not prevent pre-eclampsia in women of any Hp phenotype (Hp 1-1, OR 0.77, 95% CI 0.22-2.71; Hp 2-1, OR 0.81, 95% CI 0.46-1.43; Hp 2-2, 0.67, 95% CI 0.34-1.33), after adjusting for HbA1c at randomisation.
  
  
  CONCLUSIONS
  The Hp phenotype did not significantly affect pre-eclampsia risk in women with type-1 diabetes.
authors.affiliation: Magee-Womens Research Institute and the Department of Obstetrics, Gynaecology and Reproductive Science, University of Pittsburgh, Pittsburgh, PA, USA. weissgerber.tracey@mayo.edu
authors.forename: T L
authors.initials: TL
authors.lastname: Weissgerber
authors.forename: R E
authors.initials: RE
authors.lastname: Gandley
authors.forename: J M
authors.initials: JM
authors.lastname: Roberts
authors.forename: C C
authors.initials: CC
authors.lastname: Patterson
authors.forename: V A
authors.initials: VA
authors.lastname: Holmes
authors.forename: I S
authors.initials: IS
authors.lastname: Young
authors.forename: D R
authors.initials: DR
authors.lastname: McCance
mesh_terms: D000975:Antioxidants / Q000378:metabolism / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006242:Haptoglobins / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D016017:Odds Ratio; D018384:Oxidative Stress / Q000187:drug effects; D010641:Phenotype; D011225:Pre-Eclampsia / Q000097:blood* / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D012307:Risk Factors; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D006242:Haptoglobins; D014810:Vitamin E; D001205:Ascorbic Acid
keywords: Haptoglobin phenotype; pre-eclampsia; pregnancy; type-1 diabetes; vitamin C; vitamin E