Summary:
Objective of study: Assess interrelations between parameters of haemostasis, fibrinolysis, acute
stage proteins and cytoadhesive molecules in gestational diabetes (GDM), which in susceptible
women is actively induced by insulin resistance.
Methods: In 33 pregnant women where based on the glucose tolerance test (75 g glucose) GDM was
revealed, repeatedly fibrinogen values were assessed (FBG 4.38 ± 0.98 g/l), the antithrombin III
activity (ATIII% 103.83 ± 14.9), t-PA Ag(4.82 ± 3.35 ng/ml), PAI-1 Ag (158.04 ± 57.7 ng/ml), D-dimer
(234.99 ± 455.36 ng/ml), plasma proteins - orosomucoid (ORM 0.506 ± 0.14 g/l), C reactive protein
(1.34 ± 0.96 g/l), transferrin (3.77 ± 0.79 g/l), prealbumin (1.86 ± 0.83 g/l) and alpha-2-macroglobulin
(A2M 2.01 ± 0.62 g/l) and cytadhesive molecules s ICAM-1(230.8 ± 57.76 ng/ml) and s E-selectin (35.50
± 16.55 ng/ml). These findings were compared with parameters of the glucose and lipid metabo-
lism and some anthropometric data (BMI, weight increments during pregnancy and birth weight
of the infant).
Results: After statistical evaluation in GDM positive correlations of FBG and BMI were found (r =
0.871, p = 0,007) and also with the weight increment during pregnancy (r = 0.934, p = 0,0007).
Hyperfibrinogenaemia is however probably compensated in stabilized cases of GDM by a higher
production of t-PA (FBG:t-PA Ag, r = 0.782, p = 0.003). In GDM a marginal positive correlation
between the value of the „atheroindex“ and the infant’s length was found r = 0.744 p = 0.0547).
s E-selectin levels in GDM correlated inversely with ATIII activity (r = -0.905, p = 0.0028).
Conclusion: The higher body weight of pregnant women with GDM is probably associated with
a higher risk of thrombophilia (elevated fibrinogen). If in pregnant women infection develops
with release of inflammatory cytokines, inducing on the endothelium expression of E-selectin,
deterioration of thrombophilia (due to a decline of ATIII) activity must be foreseen.
This work was supported by the Grant Agency of the Ministry of Health of the Czech Republic -
grant. No. 3310-4.
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