title: The association of endothelial nitric oxide synthase gene G894T polymorphism and serum nitric oxide concentration with microalbuminuria in patients with gestational diabetes.
abstract: OBJECTIVE
  Gestational diabetes mellitus (GDM) is a glucose intolerant condition that affects 14% of all pregnancies. Diabetes mellitus (DM) occurs in 30 - 70% of patients with GDM after delivery. DM and GDM are associated with structural and functional deterioration of the renovascular system. Our aim is to investigate the association Glu- 298Asp polymorphism of the endothelial nitric oxide synthase (eNOS) gene with serum nitric oxide levels and microalbuminuria in patients with GDM and healthy pregnancies.
  
  
  METHODS
  Serum nitric oxide (NO) levels, urinary excretion of albumin and Glu298Asp polymorphism of the eNOS gene were analyzed in 68 patients with GDM and 73 healthy controls. High performance liquid chromatography (HPLC-Griess) method was used to analyze serum NO levels. Microalbuminuria was evaluated by rate nephelometry method. The Glu298Asp polymorphism of the eNOS gene was determined by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP).
  
  
  RESULTS
  Nitric oxide, glucose, creatinine, and microalbuminuria were significantly different between the patients and the control subjects (p = 0.001, p = 0.001, p = 0.002, and p = 0.005, respectively). There was a significant difference between groups in terms of the ratio of GG/GT+TT of eNOS gene Glu- 298Asp (p = 0.02). The patients with GT+TT genotype had significantly higher microalbuminuria levels and lower NO concentrations (22.16 vs. 9.51, p = 0.005, and 10.56 vs. 12.73, p = 0.021, respectively). The presence of T allele of eNOS gene is an independent predictor of microalbuminuria (OR: 2.346, 95% confidence interval: 1.247 - 5.238, p = 0.02) as well as serum glucose and NO concentration.
  
  
  CONCLUSIONS
  The G894T polymorphism of eNOS gene and decreased NO concentration seem to be independent predictors of increased urinary excretion of albumin in patients with GDM. Determining the frequency of eNOS gene G894T polymorphism may help to identify pregnancies at increased risk of microalbuminuria.
authors.affiliation: Department of Internal Medicine, BagcÄ±lar Education and Research Hospital, Istanbul, Department of Medical Biology, Medical School of Harran University, SanlÄ±urfa, Department of Physiology, Medical School of Mustafa Kemal University, Hatay, Department of Obstetrics and Gynecology, Suleymaniye Education and Research Hospital, Istanbul, Department of Obstetrics and Gynecology, Medical Faculty of Harran University, SanlÄ±urfa, and Department of Medical Biology and Genetics, Medical Faculty of Dicle University, Diyarbakir, Turkey.
authors.forename: Ahmet Engin
authors.initials: AE
authors.lastname: Atay
authors.forename: Halit
authors.initials: H
authors.lastname: Akbas
authors.forename: Cemil
authors.initials: C
authors.lastname: Tumer
authors.forename: Mehmet Nafi
authors.initials: MN
authors.lastname: Sakar
authors.forename: Bennur
authors.initials: B
authors.lastname: Esen
authors.forename: Adnan
authors.initials: A
authors.lastname: Incebiyik
authors.forename: Selda
authors.initials: S
authors.lastname: Simsek
authors.forename: Dede
authors.initials: D
authors.lastname: Sit
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000097:blood / Q000201:enzymology / Q000235:genetics*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002851:Chromatography, High Pressure Liquid; D016640:Diabetes, Gestational / Q000097:blood / Q000201:enzymology / Q000235:genetics*; D003928:Diabetic Nephropathies / Q000097:blood / Q000201:enzymology / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D009391:Nephelometry and Turbidimetry; D009569:Nitric Oxide / Q000097:blood*; D052250:Nitric Oxide Synthase Type III / Q000235:genetics*; D016017:Odds Ratio; D010641:Phenotype; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III