Growth factor concentrations and their placental mRNA expression are modulated in gestational diabetes mellitus: possible interactions with macrosomia

<p>Abstract</p> <p>Background</p> <p>Gestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. GDM is a well known risk factor for foetal overgrowth, termed macrosomia which is influenced by maternal hypergycemia and endocrine status through placental circulation. The study was undertaken to investigate the implication of growth factors and their receptors in GDM and macrosomia, and to discuss the role of the materno-foeto-placental axis in the <it>in-utero </it>regulation of foetal growth.</p> <p>Methods</p> <p>30 women with GDM and their 30 macrosomic babies (4.75 ± 0.15 kg), and 30 healthy age-matched pregnant women and their 30 newborns (3.50 ± 0.10 kg) were recruited in the present study. Serum concentrations of GH and growth factors, <it>i.e</it>., IGF-I, IGF-BP3, FGF-2, EGF and PDGF-B were determined by ELISA. The expression of mRNA encoding for GH, IGF-I, IGF-BP3, FGF-2, PDGF-B and EGF, and their receptors, <it>i.e</it>., GHR, IGF-IR, FGF-2R, EGFR and PDGFR-β were quantified by using RT-qPCR.</p> <p>Results</p> <p>The serum concentrations of IGF-I, IGF-BP3, EGF, FGF-2 and PDGF-B were higher in GDM women and their macrosomic babies as compared to their respective controls. The placental mRNA expression of the growth factors was either upregulated (FGF-2 or PDGF-B) or remained unaltered (IGF-I and EGF) in the placenta of GDM women. The mRNA expression of three growth factor receptors, <it>i.e</it>., IGF-IR, EGFR and PDGFR-β, was upregulated in the placenta of GDM women. Interestingly, serum concentrations of GH were downregulated in the GDM women and their macrosomic offspring. Besides, the expression of mRNAs encoding for GHR was higher, but that encoding for GH was lower, in the placenta of GDM women than control women.</p> <p>Conclusions</p> <p>Our results demonstrate that growth factors might be implicated in GDM and, in part, in the pathology of macrosomia via materno-foeto-placental axis.</p

Six-minute walk test in non-insulin-dependent diabetes mellitus patients living in Northwest Africa

Imed Latiri,1 Rihab Elbey,1 Kamel Hcini,1 Afif Zaoui,2 Bessam Charfeddine,3 Mohamed Ridha Maarouf,4 Zouhair Tabka,1,5 Abdelkrim Zbidi,1,5 Helmi Ben Saad1,51Laboratory of Physiology, University of Sousse, 2Department of Physical Medicine. Sahloul Hospital, 3Laboratory of Biochemistry, Basic Health Group, 4Basic Health Group, 5Department of Physiology and Functional Exploration, Farhat Hached Hospital, Sousse, TunisiaIntroduction: International recommendations of the exploration of non-insulin-dependent diabetes mellitus (NIDDM) are focused on deficiency and not incapacity.Aims: (1) To estimate the incapacity of NIDDM patients through the 6-minute walk test (6MWT) data. (2) To determine their 6-minute walk distance (6MWD) influencing factors (3) To compare data of NIDDM patient group (PG; n = 100) with those of two control groups (CG): CG1 (n = 174, healthy nonobese and nonsmoker); CG2 (n = 55, obese nondiabetic free from comorbidities).Population and methods: The anthropometric, socioeconomic, clinical, metabolic, and 6MWT data of 100 NIDDM patients (45 females) were collected.Results: Total sample means &amp;plusmn; standard deviation of age, weight, and height were 54 &amp;plusmn; 8 years, 81 &amp;plusmn; 14 kg, and 1.64 &amp;plusmn; 0.09 m. (1) Measured 6MWD (566 &amp;plusmn; 81 m) was significantly lower than the theoretical 6MWD (90% &amp;plusmn; 12%). The profile of the PG carrying the 6MWT, was as follows: 23% had an abnormal 6MWD; at the end of the 6MWT, 21% and 12% had, respectively, a low heart rate and a high dyspnea (&amp;gt;5/10), and 4% had desaturation during the walk. The estimated &amp;quot;cardiorespiratory and muscular chain&amp;quot; age (68 &amp;plusmn; 16 years) was significantly higher than the chronological age. (2) The factors that significantly influenced the 6MWD (r2 = 0.58) are included in the following equation: 6MWD (m) = &amp;ndash;73.94 &amp;times; gender (0, male; 1, female) &amp;ndash; 3.25 &amp;times; age (years) + 7.33 &amp;times; leisure activity score &amp;ndash; 35.57 &amp;times; obesity (0, no; 1, yes) + 32.86 &amp;times; socioeconomic level (0, low; 1, high) &amp;ndash; 27.67 &amp;times; cigarette use (0, no; 1, yes) + 8.89 &amp;times; resting oxyhemoglobin saturation &amp;ndash; 105.48. (3) Compared to the CGs, the PG had a significantly (P &amp;lt; 0.05) lower 6MWD (100%+9% and 100%+8%, respectively, for the CG1 and CG2).Conclusion: NIDDM seems to accelerate the decline of the submaximal aerobic capacity evaluated through the 6MWD.Keywords: 6-minute walk test, non-insulin-dependent diabetes mellitus, physical activity, functional incapacit