Associations Among Biomarkers of Inflammation, Tubular Injury and Lipid Metabolism With Gestational Diabetes Mellitus Status, Microalbuminuria and Retinopathy in the Microalbuminuria and Retinopathy in Gestational Diabetes Study

Objectives: Pregnancy may be complicated by gestational diabetes mellitus (GDM) and/or microvascular complications like albuminuria, retinopathy and pre-eclampsia. In this study we aimed to identify whether mechanistic pathways associated with microvascular complications are active in pregnant women with GDM or microvascular disease. Methods: Urinary albumin excretion and biomarkers of inflammation, lipoprotein metabolism and tubular injury were quantified in 355 pregnant women with and without GDM. Participants underwent fundus photography graded for retinopathy. Adjusted associations between individual biomarkers and each outcome variable of interest, including GDM status, albuminuria and retinopathy, were performed using logistic regression. Results: After adjusting for age, systolic blood pressure, body mass index and ethnicity, significant associations between GDM status and apolipoprotein A1, interleukin (IL)-6, IL-8, soluble tumour necrosis factor receptor-I and -II (sTNFR-I and -II), vascular endothelial growth factor and von Willebrand factor were observed. Increased high-sensitivity C-reactive protein (hsCRP) and sTNFR-II were associated with higher levels of albuminuria. hsCRP and previous GDM were associated with retinopathy. Conclusion: Mechanistic pathways associated with microvascular complications appear to be active in pregnant women with GDM or microvascular disease. (c) 2022 Canadian Diabetes Association.

Automated summary

This study aimed to investigate the mechanistic pathways associated with microvascular complications in pregnant women with gestational diabetes mellitus (GDM) or microvascular disease. The results showed significant associations between GDM status and various biomarkers, including apolipoprotein A1, interleukin (IL)-6, IL-8, soluble tumour necrosis factor receptor-I and -II, vascular endothelial growth factor, and von Willebrand factor. Elevated levels of high-sensitivity C-reactive protein and soluble tumour necrosis factor receptor-II were associated with increased albuminuria, while high-sensitivity C-reactive protein and previous GDM were associated with retinopathy. These findings suggest that mechanistic pathways related to microvascular complications are active in pregnant women with GDM or microvascular disease.