Gestational Diabetes Mellitus Clinical Trial
Official title:
Influence of the Adipocytokines Apelin, Omentin, Resistin and Visfatin on Lipid Metabolism and Gestational Diabetes Mellitus
Apelin, Visfatin, Omentin and Resistin are adipocytokines derived from human adipose tissue
as well as placental tissue and have been shown to be potential mediators of insulin
resistance. In each pregnancy, a physiological Insulin resistance syndrome occurs to ensure
that the fetus is sufficiently supplied with glucose. Due to their impact on glucose
transport mechanisms adipocytokines play an important role for the development of insulin
resistance.
Gestational diabetes mellitus (GDM) is one of the most common pregnancy - associated
diseases with a prevalence of 5-10% of all pregnancies and its prevalence is increasing. It
is associated with severe hazards to both mother and fetus such as macrosomia, plexus palsy,
premature delivery and intrauterine death. Furthermore, up to 50% of women with GDM develop
Type 2 Diabetes Mellitus (DM2) within the following ten years after pregnancy. GDM seems to
be a potent risk factor for the development of DM2 in later life by sharing a number of
epidemiological, physiological and genetic characteristics with DM2. Therefore, alterations
in adipocytokine levels in women with GDM, if present, may resemble those observed with DM2.
Furthermore, the exact pathogenesis of GDM is not completely understood, however, increased
insulin resistance is a well demonstrated mechanism.
Adipocytokines are known to alter insulin resistance through several mechanisms described in
the literature. The investigators therefore expect a possible relationship between the above
described adipocytokines and gestational diabetes mellitus.
Results of the HAPO-Study have shown a significant association between fetal outcome and
mean blood glucose levels in women suffering from GDM. The HAPO Study group supposed a
possible relationship between GDM and fetal insulin levels and used C-Peptide to quantify
fetal hyperinsulinemia.
A recent study suggests that not only hyperglycemia but also altered maternal lipid
metabolism may constitute a risk factor for macrosomia in GDM.
In summary, the investigators aim to illuminate a possible association between the
adipocytokines Apelin, Omentin, Resistin and Visfatin, lipid metabolism and gestational
diabetes mellitus.
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Observational Model: Cohort, Time Perspective: Prospective
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