Araştırma Makalesi
Yıl 2017,
, 173 - 177, 01.12.2017
Öz
Aim: Osteopontin (OPN) has recently been considered as a marker of coronary artery disease. The aim of this study is to evaluate OPN levels and investigate their correlation with the high sensitivity-CRP (hs-CRP) levels in patients with gestational diabetes mellitus (GDM), an increased state of insulin resistance.
Materials and Methods: Fifty-four GDM patients and 40 healthy pregnant patients were included in this study. Biochemical tests for lipid profile, fasting blood glucose, oral glucose tolerance test, OPN, HOMA-IR and hs-CRP were done at 24th gestational week. Serum levels of OPN were measured by enzyme-linked immunosorbent assays (ELISAs), serum hs-CRP levels were measured by particle association turbidometric assay.
Results: Gestational week, age, BMI of two groups were similar (p > 0.05). The GDM group had significantly higher fasting, and post-load (1st and 2nd hour) blood glucose, HbA1c, fasting insulin and HOMA-IR levels than those of the healthy group. Except triglyceride levels, the lipid profiles of two groups were not significantly different. The GDM group had higher triglyceride levels than the control group (p<0.05). The OPN levels were 3.6±2.2 ng/mL in the GDM and 3.4±2.6 ng/mL in the control groups (p>0.05). The hs-CRP levels were 0.94±0.8 mg/dL, 0.57±0.5 mg/dL in the GDM and control groups, respectively (p<0.05). There was no correlation between the OPN and hs-CRP levels (r=0.080; p=0.442). In GDM the patients are experiencing rapid metabolic changes, so these metabolic changes may not affect the level of OPN.
Conclusion: OPN levels were not significantly increased in GDM patients.
Anahtar Kelimeler
Kaynakça
- 1) Jovanovic L, Pettitt DJ. Gestational diabetes mellitus. JAMA 2001;286(20):2516-8.
- 2) Dennedy MC, Dunne F. The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome. Best Pract Res Clin Endocrinol Metab 2010;24(4):573-89.
- Kaufmann RC, Schleyhahn FT, Huffman DG, Amankwah KS. Gestational diabetes diagnostic criteria: Long-term maternal follow-up. Am J Obstet Gynecol 1995;172 (2 Pt 1):621-5.
- Akinci B, Celtik A, Genc S, et al. Evaluation of postpartum carbohydrate intolerance and cardiovascular risk factors in women with gestational diabetes. Gynecol Endocrinol 2011;27(5):361-7.
- Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects: Associations with obesity, insulin resistance, and endothelial dysfunction: A potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999;19(4):972-8.
- Stern MP. Diabetes and cardiovascular disease. The "common soil" hypothesis. Diabetes 1995; 44(4):369-74.
- Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342(12):836-43.
- Retnakaran R, Hanley AJ, Raif N, Connelly PW, Sermer M, Zinman B. C-reactive protein and gestational diabetes: The central role of maternal obesity. J Clin Endocrinol Metab 2003;88(8):3507-12.
- Scatena M, Liaw L, Giachelli CM. Osteopontin. A multifunctional molecule regulating chronic inflammation and vascular disease. Arterioscler Thromb Vasc Biol 2007;27(11):2302-9.
- Kahles F, Findeisen HM, Bruemmer D. Osteopontin: A novel regulator at the cross roads of inflammation, obesity and diabetes. Mol Metab 2014;3(4):384-93.
- Tousoulis D, Siasos G, Maniatis K, et al. Serum osteoprotegerin and osteopontin levels are associated with arterial stiffness and the presence and severity of coronary artery disease. Int J Cardiol 2012;167(5):1924-8.
- Wendelin-Saarenhovi M, Oikonen M, Loo BM, et al. Plasma osteopontin is not associated with vascular markers of subclinical atherosclerosis in a population of young adults without symptoms of cardiovascular disease. The cardiovascular risk in young finns study. Scand J Clin Lab Invest 2011;71(8):683-9.
- Ahmad R, Al-Mass A, Al-Ghawas D, et al. Interaction of osteopontin with IL-18 in obese individuals: Implications for insulin resistance. PLoS One 2013;8(5):e63944.
- Stenczer B, Rigo J, Prohaszka Z, et al. Plasma osteopontin concentrations in preeclampsia - is there an association with endothelial injury? Clin Chem Lab Med 2010;48(2):181-7.
- Hauth JC, Clifton RG, Roberts JM, et al. Maternal insulin resistance and preeclampsia. Am J Obstet Gynecol 2011;204(4):327 e321-6.
- Winhofer Y, Kiefer FW, Handisurya A, et al. Ctx (crosslaps) rather than osteopontin is associated with disturbed glucose metabolism in gestational diabetes. PLoS One 2012;7(7):e40947.
- Metzger BE, Gabbe SG, Persson B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010;33(3):676-82.
- Tiniakos DG, Yu H, Liapis H. Osteopontin expression in ovarian carcinomas and tumors of low malignant potential (lmp). Hum Pathol 1998;29(11):1250-4.
- Rossner SM, Neovius M, Montgomery SM, Marcus C, Norgren S. Alternative methods of insulin sensitivity assessment in obese children and adolescents. Diabetes Care 2008;31(4):802-4.
- Catalano PM, Kirwan JP, Haugel-de Mouzon S, King J. Gestational diabetes and insulin resistance: Role in short- and long-term implications for mother and fetus. J Nutr 2003;133(5 Suppl 2):1674S-83S.
- Brizzi P, Tonolo G, Esposito F, et al. Lipoprotein metabolism during normal pregnancy. Am J Obstet Gynecol 1999;181(2):430-4.
- Wiznitzer A, Mayer A, Novack V, et al. Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: A population-based study. Am J Obstet Gynecol 2009;201(5):482 e481-8.
- Piechota W, Staszewski A. Reference ranges of lipids and apolipoproteins in pregnancy. Eur J Obstet Gynecol Reprod Biol 1992;45(1):27-35.
- Ridker PM, Hennekens CH, Roitman-Johnson B, Stampfer MJ, Allen J. Plasma concentration of soluble intercellular adhesion molecule 1 and risks of future myocardial infarction in apparently healthy men. Lancet 1998;351(9096):88-92.
- Heitritter SM, Solomon CG, Mitchell GF, Skali-Ounis N, Seely EW. Subclinical inflammation and vascular dysfunction in women with previous gestational diabetes mellitus. J Clin Endocrinol Metab 2005;90(7):3983-8.
- Bo S, Valpreda S, Menato G, et al. Should we consider gestational diabetes a vascular risk factor? Atherosclerosis 2007;194(2):e72-9.
- Naldini A, Leali D, Pucci A, et al. Cutting edge: Il-1beta mediates the proangiogenic activity of osteopontin-activated human monocytes. J Immunol 2006;177(7):4267-70.
- Yu M, Liu Q, Yi K, Wu L, Tan X. Effects of osteopontin on functional activity of late endothelial progenitor cells. J Cell Biochem 2011;112(7):1730-6.
- Momiyama Y, Ohmori R, Fayad ZA, et al. Associations between plasma osteopontin levels and the severities of coronary and aortic atherosclerosis. Atherosclerosis 2010;210(2):668-70.
- Nakamachi T, Nomiyama T, Gizard F, et al. PPAR-alpha agonists suppress osteopontin expression in macrophages and decrease plasma levels in patients with type 2 diabetes. Diabetes 2007;56(6):1662-70.
- Yan X, Sano M, Lu L, et al. Plasma concentrations of osteopontin, but not thrombin-cleaved osteopontin, are associated with the presence and severity of nephropathy and coronary artery disease in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2010;9:70.
- Berezin AE, Kremzer AA. Circulating osteopontin as a marker of early coronary vascular calcification in type two diabetes mellitus patients with known asymptomatic coronary artery disease. Atherosclerosis 2013;229(2):475-81.
- Riedl M, Vila G, Maier C, et al. Plasma osteopontin increases after bariatric surgery and correlates with markers of bone turnover but not with insulin resistance. J Clin Endocrinol Metab 2008;93(6):2307-12.
- Nilsson-Berglund LM, Zetterqvist AV, Nilsson-Ohman J, et al. Nuclear factor of activated t cells regulates osteopontin expression in arterial smooth muscle in response to diabetes-induced hyperglycemia. Arterioscler Thromb Vasc Biol 2010;30(2):218-24.
Yıl 2017,
, 173 - 177, 01.12.2017
Öz
Amaç: Osteopontin (OPN) son zamanlarda koroner arter hastalığının bir belirteci olarak düşünülmektedir. Bu çalışmada, insulin direncinin arttığı bir durum olan gestasyonel diabetes mellituslu (GDM) hastalarda,OPN seviyelerini ve bunun sensitif CRP (hs-CRP) seviyeleri ile korelasyonunu incelemek istedik.
Gereç ve Yöntem: Çalışmaya 54 GDM ve 40 sağlıklı hamile alındı. 24. Gebelik haftasında kan lipid düzeyleri, oral glukoz yükleme testi, OPN, HOMA-IR, hs-CRP düzeyleri için kan tahlilleri yapıldı. Serum OPN düzeyleri ELISA, hs-CRP düzeyleri parçacık ilişkili turbidimetrik test ile ölçüldü.
Bulgular: Her iki grubun gestasyonel haftası, yaş, VKI benzerdi (p > 0.05). GDM grubunda açlık glukoz, OGTT te 1 ve 2. saat kan glukoz, HbA1c, açlık insulin, HOMA-IR değerleri kontrol grubuna göre istatistiksel olarak anlamlı daha yüksek saptandı. Trigliserid seviyeleri dışında lipid profilerinde her iki grupta anlamlı fark saptanmadı. GDM grubunda kontrol grubuna göre trigliserid seviyeleri daha yüksek saptandı (p<0.05). GDM grubunda OPN seviyesi 3.6±2.2 ng/mL, kontrol grubunda 3.4±2.6 ng/mL saptandı (p>0.05). GDM ve kontrol gruplarında hs-CRP seviyeleri sırasıyla 0.94±0.8 mg/dL, 0.57±0.5 mg/dL saptandı (p<0.05). OPN ve hs-CRP seviyelerinde anlamlı korelasyon saptanmadı (r=0.080; p=0.442). Gestasyonel diyabette hastalar hızlı metabolik değişiklikler yaşadığı için metabolik değişiklikler OPN seviyesini etkilemeyebilir.
Sonuç: GDM’lu hastalarda OPN seviyelerinde anlamlı artış saptanmamıştır.
Anahtar Kelimeler
Kaynakça
- 1) Jovanovic L, Pettitt DJ. Gestational diabetes mellitus. JAMA 2001;286(20):2516-8.
- 2) Dennedy MC, Dunne F. The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome. Best Pract Res Clin Endocrinol Metab 2010;24(4):573-89.
- Kaufmann RC, Schleyhahn FT, Huffman DG, Amankwah KS. Gestational diabetes diagnostic criteria: Long-term maternal follow-up. Am J Obstet Gynecol 1995;172 (2 Pt 1):621-5.
- Akinci B, Celtik A, Genc S, et al. Evaluation of postpartum carbohydrate intolerance and cardiovascular risk factors in women with gestational diabetes. Gynecol Endocrinol 2011;27(5):361-7.
- Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects: Associations with obesity, insulin resistance, and endothelial dysfunction: A potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999;19(4):972-8.
- Stern MP. Diabetes and cardiovascular disease. The "common soil" hypothesis. Diabetes 1995; 44(4):369-74.
- Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342(12):836-43.
- Retnakaran R, Hanley AJ, Raif N, Connelly PW, Sermer M, Zinman B. C-reactive protein and gestational diabetes: The central role of maternal obesity. J Clin Endocrinol Metab 2003;88(8):3507-12.
- Scatena M, Liaw L, Giachelli CM. Osteopontin. A multifunctional molecule regulating chronic inflammation and vascular disease. Arterioscler Thromb Vasc Biol 2007;27(11):2302-9.
- Kahles F, Findeisen HM, Bruemmer D. Osteopontin: A novel regulator at the cross roads of inflammation, obesity and diabetes. Mol Metab 2014;3(4):384-93.
- Tousoulis D, Siasos G, Maniatis K, et al. Serum osteoprotegerin and osteopontin levels are associated with arterial stiffness and the presence and severity of coronary artery disease. Int J Cardiol 2012;167(5):1924-8.
- Wendelin-Saarenhovi M, Oikonen M, Loo BM, et al. Plasma osteopontin is not associated with vascular markers of subclinical atherosclerosis in a population of young adults without symptoms of cardiovascular disease. The cardiovascular risk in young finns study. Scand J Clin Lab Invest 2011;71(8):683-9.
- Ahmad R, Al-Mass A, Al-Ghawas D, et al. Interaction of osteopontin with IL-18 in obese individuals: Implications for insulin resistance. PLoS One 2013;8(5):e63944.
- Stenczer B, Rigo J, Prohaszka Z, et al. Plasma osteopontin concentrations in preeclampsia - is there an association with endothelial injury? Clin Chem Lab Med 2010;48(2):181-7.
- Hauth JC, Clifton RG, Roberts JM, et al. Maternal insulin resistance and preeclampsia. Am J Obstet Gynecol 2011;204(4):327 e321-6.
- Winhofer Y, Kiefer FW, Handisurya A, et al. Ctx (crosslaps) rather than osteopontin is associated with disturbed glucose metabolism in gestational diabetes. PLoS One 2012;7(7):e40947.
- Metzger BE, Gabbe SG, Persson B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010;33(3):676-82.
- Tiniakos DG, Yu H, Liapis H. Osteopontin expression in ovarian carcinomas and tumors of low malignant potential (lmp). Hum Pathol 1998;29(11):1250-4.
- Rossner SM, Neovius M, Montgomery SM, Marcus C, Norgren S. Alternative methods of insulin sensitivity assessment in obese children and adolescents. Diabetes Care 2008;31(4):802-4.
- Catalano PM, Kirwan JP, Haugel-de Mouzon S, King J. Gestational diabetes and insulin resistance: Role in short- and long-term implications for mother and fetus. J Nutr 2003;133(5 Suppl 2):1674S-83S.
- Brizzi P, Tonolo G, Esposito F, et al. Lipoprotein metabolism during normal pregnancy. Am J Obstet Gynecol 1999;181(2):430-4.
- Wiznitzer A, Mayer A, Novack V, et al. Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: A population-based study. Am J Obstet Gynecol 2009;201(5):482 e481-8.
- Piechota W, Staszewski A. Reference ranges of lipids and apolipoproteins in pregnancy. Eur J Obstet Gynecol Reprod Biol 1992;45(1):27-35.
- Ridker PM, Hennekens CH, Roitman-Johnson B, Stampfer MJ, Allen J. Plasma concentration of soluble intercellular adhesion molecule 1 and risks of future myocardial infarction in apparently healthy men. Lancet 1998;351(9096):88-92.
- Heitritter SM, Solomon CG, Mitchell GF, Skali-Ounis N, Seely EW. Subclinical inflammation and vascular dysfunction in women with previous gestational diabetes mellitus. J Clin Endocrinol Metab 2005;90(7):3983-8.
- Bo S, Valpreda S, Menato G, et al. Should we consider gestational diabetes a vascular risk factor? Atherosclerosis 2007;194(2):e72-9.
- Naldini A, Leali D, Pucci A, et al. Cutting edge: Il-1beta mediates the proangiogenic activity of osteopontin-activated human monocytes. J Immunol 2006;177(7):4267-70.
- Yu M, Liu Q, Yi K, Wu L, Tan X. Effects of osteopontin on functional activity of late endothelial progenitor cells. J Cell Biochem 2011;112(7):1730-6.
- Momiyama Y, Ohmori R, Fayad ZA, et al. Associations between plasma osteopontin levels and the severities of coronary and aortic atherosclerosis. Atherosclerosis 2010;210(2):668-70.
- Nakamachi T, Nomiyama T, Gizard F, et al. PPAR-alpha agonists suppress osteopontin expression in macrophages and decrease plasma levels in patients with type 2 diabetes. Diabetes 2007;56(6):1662-70.
- Yan X, Sano M, Lu L, et al. Plasma concentrations of osteopontin, but not thrombin-cleaved osteopontin, are associated with the presence and severity of nephropathy and coronary artery disease in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2010;9:70.
- Berezin AE, Kremzer AA. Circulating osteopontin as a marker of early coronary vascular calcification in type two diabetes mellitus patients with known asymptomatic coronary artery disease. Atherosclerosis 2013;229(2):475-81.
- Riedl M, Vila G, Maier C, et al. Plasma osteopontin increases after bariatric surgery and correlates with markers of bone turnover but not with insulin resistance. J Clin Endocrinol Metab 2008;93(6):2307-12.
- Nilsson-Berglund LM, Zetterqvist AV, Nilsson-Ohman J, et al. Nuclear factor of activated t cells regulates osteopontin expression in arterial smooth muscle in response to diabetes-induced hyperglycemia. Arterioscler Thromb Vasc Biol 2010;30(2):218-24.
Toplam 34 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2017 |
| Gönderilme Tarihi | 25 Ağustos 2016 |
| Yayımlandığı Sayı | Yıl 2017 |