Trace elements as predictors of preeclampsia in type 1 diabetic pregnancy.
Preeclampsia (PE) affects approximately 5% of all pregnancies, but is increased several-fold in women with pre-gestational type 1 diabetes mellitus (T1DM). Increased oxidative stress and altered maternal plasma trace elements that modulate the antioxidant system have been implicated in PE. In non-diabetic women, increased plasma copper and iron and decreased manganese, selenium, and zinc have been associated with PE in cross-sectional studies. In a longitudinal study, we hypothesized that plasma levels of trace elements differ between T1DM women with vs. without subsequent PE. Samples were collected during the first (gestation 12.2 ± 1.9 weeks, [mean ± SD]), second (21.6 ± 1.5 weeks), and third (31.5 ± 1.7 weeks) trimesters of pregnancy, all before the onset of PE. We compared 23 T1DM women who subsequently developed PE with 24 T1DM women who remained normotensive; and we included 19 non-diabetic (non-DM) normotensive pregnant women as reference controls. Trace elements were measured using inductively coupled plasma mass spectroscopy. In T1DM women with subsequent PE vs normotensive, only plasma zinc was significantly higher at the first trimester, while copper:zinc and copper:high-density lipoprotein cholesterol ratios were higher throughout gestation (all P < .05). These findings persisted after adjustment for covariates. Higher copper:zinc ratios may contribute to oxidative stress in T1DM women who develop PE. Ratios of pro- to anti-oxidant factors may predict risk for PE in diabetic pregnancies more effectively than individual trace element levels.
Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA. Electronic address: arpita.basu@okstate.edu.
Arpita
A
Basu
Centre for Experimental Medicine, Queen's University of Belfast, Belfast, Northern Ireland, UK.
Jeremy Y
JY
Yu
Centre for Experimental Medicine, Queen's University of Belfast, Belfast, Northern Ireland, UK; University of Sydney, NHMRC Clinical Trials Centre, Camperdown, Sydney, NSW, Australia.
Alicia J
AJ
Jenkins
Diabetes Service, The Royal Women's Hospital, Melbourne, Australia.
Alison J
AJ
Nankervis
Department of Endocrinology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Kristian F
KF
Hanssen
Department of Gynecology and Obstetrics, Oslo University Hospital, Oslo, Norway.
Tore
T
Henriksen
Department of Gynecology and Obstetrics, Oslo University Hospital, Oslo, Norway.
Bjørg
B
Lorentzen
Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Aurora, CO, USA.
Satish K
SK
Garg
Division of Maternal Fetal Medicine, University of North Carolina, Chapel Hill, NC, USA.
M Kathryn
MK
Menard
Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC, USA.
Samar M
SM
Hammad
Spartanburg Regional Medical Center, Spartanburg, SC, USA.
James A
JA
Scardo
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Christopher E
CE
Aston
Centre for Experimental Medicine, Queen's University of Belfast, Belfast, Northern Ireland, UK; Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Timothy J
TJ
Lyons
D000328:Adult; D001315:Australia / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D003300:Copper / Q000097:blood*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009664:Norway / Q000453:epidemiology; D018384:Oxidative Stress; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood* / Q000503:physiopathology; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D012306:Risk; D014481:United States / Q000453:epidemiology; D015032:Zinc / Q000097:blood*
D015415:Biomarkers; D008076:Cholesterol, HDL; D003300:Copper; D015032:Zinc
Copper; Oxidative stress; Preeclampsia; Selenium; Type 1 diabetes; Zinc