Süleyman Baldane, Süleyman Hilmi İPEKCİ, Ayşegül KEBAPCILAR, Sedat ABUŞOĞLU, Bahadır ÖZTÜRK, Ali ÜNLÜ, Çetin ÇELİK, Levent KEBAPCILAR

Gestasyonel diabetes mellitus tanısında bir biyobelirteç olarak serum prokalsitonin düzeyi

Amaç: Bu çalışmanın amacı gestasyonel diabetes mellitus hastalarında ve sağlıklı gebelerde serum prokalsitonin düzeylerini karşılaştırmak ve prokalsitonin düzeyinin diğer metabolik parametreler ile ilişkisini değerlendirilmesidir. Gereç ve Yöntem: Endokrinoloji Bilim Dalı polikliniğine başvuran 142 gebe çalışmaya dahil edildi. Oral glukoz tolerans testi sonuçlarına göre 57 gebeye gestasyonel diabet mellitus tanısı konuldu. 85 sağlıklı gebe ise kontrol grubuna dahil edildi. Serum analizi için tüm kan örnekleri bir gecelik açlık sonrası oral glukoz tolerans testi başlangıcında sabah 7:00 ve 8:00 saatleri arasında alındı.Bulgular: Gestasyonel diabet mellitus grubunda serum prokalsitonin düzeyleri kontrol grubuna göre anlamlı olarak yüksek bulundu. Serum prokalsitonin düzeyi ile açlık glukozu ve oral glukoz tolerans testi 60. dakika glukoz düzeyleri arasında anlamlı pozitif korelasyon bulundu.Sonuç: Bu çalışmada gestasyonel diabet mellitus’lu gebelerde serum prokalsitonin düzeylerinin sağlıklı gebelere göre anlamlı olarak yüksek olduğu ilk kez gösterilmiştir. Bu sonuç kronik düşük-dereceli inflamasyonun gestasyonel diabet mellitus patogenezinde önemli role sahip olduğu bilgisini desteklemektedir. Prokalsitonin düzeyi gestasyonel diabet mellitus hastalarında kronik düşük-dereceli inflamasyonun yeni bir biyobelirteci olarak düşünülebilir.

Anahtar Kelimeler:

Gestasyonel diabetes mellitus, prokalsitonin, inflamasyon

Serum procalcitonin levels as a biomarker for diagnosis gestational diabetes mellitus

Purpose: The aim of this study was set as to compare procalcitonin levels of gestational diabetes mellitus patients and healthy pregnant individuals and evaluate link between serum procalcitonin concentration and metabolic parameters of gestational diabetes mellitus. Materials and Methods: 142 pregnant individual who consulted to Endocrinology Division were taken to the study. According to the oral glucose tolerance test results, 57 were diagnosed gestational diabetes mellitus, and 85 healthy pregnant were included in the control group. For the serum analysis, samples were obtained after overnight fasting and between 7:00 AM and 8:00 AM.Results: In the gestational diabetes mellitus group serum procalcitonin levels was found significantly higher than control group. A positive correlation was found between serum procalcitonin levels and fasting glucose and oral glucose tolerance test 60. minute glucose levels. Conclusion: Our results shown that levels of serum procalcitonin in gestational diabetic mellitus were significantly higher than healthy pregnancies for the first time. This result supports the knowledge that chronic low-grade inflammation plays an important role in the pathogenesis of gestational diabetes mellitus. Procalcitonin level may be considered as a new biomarker for chronic low-grade inflammation in patients with gestational diabetes mellitus

Keywords:

Gestational diabetes mellitus, procalcitonin,

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1. Buchanan TA, Xiang AH, Page KA. Gestational diabetes mellitus: risks and management during and after pregnancy. Nat Rev Endocrinol. 2012;8:639-49.
2. Lauenborg J, Hansen T, Jensen DM, Vestergaard H, Mølsted-Pedersen L, Hornnes P et al. Increasing incidence of diabetes after gestational diabetes: a long-term follow-up in a Danish population. Diabetes Care. 2004;27:1194-9.
3. Lekva T, Norwitz ER, Aukrust P, Ueland T. Impact of systemic inflammation on the progression of gestational diabetes mellitus. Curr Diab Rep. 2016;16:26.
4. Rezvan N, Hosseinzadeh-Attar MJ, Masoudkabir F, Moini A, Janani L, Mazaherioun M. Serum visfatin concentrations in gestational diabetes mellitus and normal pregnancy. Arch Gynecol Obstet. 2012;285:1257-62.
5. Aktas G, Alcelik A, Ozlu T, Tosun M, Tekce BK, Savli H et al. Association between omentin levels and insulin resistance in pregnancy. Exp Clin Endocrinol Diabetes. 2014;122:163-6.
6. Linscheid P, Seboek D, Nylen ES, Langer I, Schlatter M, Becker KL et al. In vitro and in vivo calcitonin I gene expression in parenchymal cells: a novel product of human adipose tissue. Endocrinology. 2003;144:5578-84.
7. Linscheid P, Seboek D, Schaer DJ, Zulewski H, Keller U, Müller B. Expression and secretion of procalcitonin and calcitonin generelated peptide by adherent monocytes and by macrophage-activated adipocytes. Crit Care Med. 2004;32:1715-21.
8. Coustan DR, Carpenter MW. The diagnosis of gestational diabetes. Diabetes Care. 1998;21:5-8.
9. Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27:1487-95.
10. McLachlan KA, O'Neal D, Jenkins A, Alford FP. Do adiponectin, TNF alpha, leptin and CRP relate to insulin resistance in pregnancy? Studies in women with and without gestational diabetes, during and after pregnancy. Diabetes Metab Res Rev. 2006;22:131-8.
11. Kuzmicki M, Telejko B, Zonenberg A, Szamatowicz J, Kretowski A, Nikolajuk A, et al. Circulating pro- and anti-inflammatory cytokines in Polish women with gestational diabetes. Horm Metab Res. 2008;40:556-60.
12. Puder JJ, Varga S, Kraenzlin M, De Geyter C, Keller U, Müller B. Central fat excess in polycystic ovary syndrome: relation to low-grade inflammation and insulin resistance. J Clin Endocrinol Metab. 2005;90:6014-21.
13. Abbasi A, Corpeleijn E, Postmus D, Gansevoort RT, de Jong PE, Gans RO et al. Plasma procalcitonin is associated with obesity, insulin resistance, and the metabolic syndrome. J Clin Endocrinol Metab. 2010;95:26-31.
14. Abbasi A, Corpeleijn E, Postmus D, Gansevoort RT, de Jong PE, Gans RO et al. Plasma procalcitonin and risk of type 2 diabetes in the general population. Diabetologia. 2011;54:2463-5.
15. van Ree RM, de Vries AP, Oterdoom LH, Seelen MA, Gansevoort RT, Schouten JP et al. Plasma procalcitonin is an independent predictor of graft failure late after renal transplantation. Transplantation. 2009;88:279-87.
16. Wan ZM, Chen WY, Lu ML, Zhou HT, Gao YL, Zhang C et al. Higher procalcitonin level in diabetic nephropathy patients compared with healthy volunteers. Sichuan Da Xue Xue Bao Yi Xue Ban. 2014;45:442-6.