Pregnancy

Researchers identify panel of biomarkers that may help predict gestational diabetes in early pregnancy

Researchers identify panel of biomarkers that may help predict gestational diabetes in early pregnancy

UCLA researchers have taken the first step in identifying what could be an effective way to detect gestational diabetes mellitus (GDM) earlier in pregnancy, potentially improving the diagnosis and treatment of what is the pregnancy disorder. The most common.

The study is published in the peer-reviewed journal PLOS ONE.

Gestational diabetes leads to an increase in blood sugar, creating risks for the baby and the mother. This can lead to high blood pressure, risk of future diabetes and increased risk of cesarean section in the mother, as well as excessive birth weight, premature delivery and other problems in her baby. Diagnosis of the disease currently relies on conventional screening and laboratory work at the end of the second and third trimesters. The ability to predict the condition earlier is a key to reducing its impact.

“As pregnancy complications continue to rise around the world, increasing efforts have been made to urgently study the first trimester as a window of opportunity for the early identification and prediction of GDM, and the optimal point to take action to prevent maternal disease,” said Dr. Sherin Devaskar, lead study author and chief medical officer of UCLA’s Mattel Children’s Hospital and Distinguished Professor of Pediatrics at the David Geffen School of Medicine at UCLA.

Identifying biomarkers of GDM in early pregnancy could lead to better monitoring and the development of safe and timely interventions and treatments that reduce disease severity, improving the long-term health outlook for both mother and child. offspring.

For the current study, the researchers focused on extracellular vesicles (EVs), circulating “communicators” that carry and deliver microRNA (miRNA) genes in maternal blood. They are secreted by the placenta and play a key role in pregnancy and pregnancy complications including DG. Researchers took blood samples during each trimester and at delivery from miRNA expression in EVs in 24 pregnant women and found that there was distinct miRNA expression in EVs electrical isolated from blood samples taken during the first trimester, in women eventually diagnosed with gestational diabetes compared to those with normal diabetes. healthy pregnancies. The authors noted changes in these miRNAs prior to clinical diagnosis, suggesting that they were involved in the development of the disease rather than due to factors secondary to the disease itself or to treatments such as insulin, which can influence the miRNA content of electric vehicles in circulation.

The researchers also found upregulation of some miRNAs in first trimester pregnancies that were later diagnosed with gestational diabetes, further suggesting that miRNA cargo in circulating EVs may communicate with d other maternal organs and cell types and interact with signaling pathways involved in metabolism and inflammation. , which may influence the maternal metabolic adaptations observed in women who develop DG.

“This is a promising first step in the search for a robust and accurate biomarker panel that performs much better than a single feature in predicting GDM in early pregnancy,” Dr. Devaskar said. “This study provides further evidence that gestational diabetes is a condition that begins to develop much earlier than when it is currently clinically diagnosed, after mid-pregnancy – when, unfortunately, complications may already be irreversible. As care providers for high-risk pregnant patients and their babies, we are excited about this step towards the potential for more reliable and earlier diagnosis so that we can intervene before adverse conditions develop for the mother and the baby that often last a lifetime.”

The authors state that further study is needed to investigate the mechanistic role of circulating EVs during pregnancy, their role in pregnancy complications, and the use of EV-associated miRNAs as noninvasive predictors of disease. during pregnancy, but that first trimester EV-associated miRNAs have the potential to act as an early gestational predictor of later development of GDM, before the emergence of characteristic clinical or biochemical features.

Other study authors included Shanthie Thamotharan, research associate, Shubhamoy Ghosh, PhD, associate project scientist, and Laura James-Allan, PhD, postdoctoral fellow, all in the UCLA Department of Pediatrics-Neonatology; Margarida YY Lei, Staff Research Associate and Dr. Carla Janzen, Associate Professor, in the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine at UCLA.

The research was supported by the National Institutes of Health under grant numbers NU01HD087221 (to SUD, CJ, KS), R01HD089714 (to SUD), and R01HD100015 (to SUD).