Abstract
Gestational Diabetes Mellitus is a glucose tolerance disorder that first begins in pregnancy or is diagnosed during pregnancy and progresses with different levels of hyperglycemia. Kisspeptins are a family of neuropeptides in the RF-Amide structure encoded by the KISS-1 gene. Kisspeptins are thought to be most secreted from the placenta during pregnancy. Although its physiological role is unclear, it is thought to behave similar to growth hormone and affect the implantation and invasion of trophoblasts. In our study; Plasma Kisspeptin-10 levels were compared in pregnant women with and without Gestational Diabetes Mellitus, and the role of kisspeptin in etiology and the effect of Kisspeptin-10 levels on perinatal outcomes were investigated. 31 pregnant women who were diagnosed with gestational diabetes by OGTT between 25 and 41 weeks of gestation and and 28 healthy pregnant women were included in the study. Plasma kisspeptin levels of volunteers were investigated. Statistical analysis of the data was made with the SPSS 20.0 statistics program. Student's t test, Mann-Whitney U test and Pearson Correlation Analysis were used. p<0.05 was considered statistically significant. There was no statistically significant difference between patients with Gestational Diabetes and patients in the control group, except for their BMI. In pregnant women with gestational diabetes, no statistically significant difference was found in terms of kisspeptin levels between those with and without insulin need, those with and without fetal distress, and those with and without neonatal intensive care need. A positive correlation was found between the kisspeptin level and the ages of the patients (R= 0.259, p=0.048). A negative correlation was found between the kisspeptin level and the weight gained (R= -0.278, p=0.033).Kisspeptin may have a role in the etiopathogenesis of Gestational Diabetes Mellitus like other hormones. We think that larger studies are needed in order to use Kisspeptin as a diagnosis, screening test and prognostic marker in Gestational Diabetes Mellitus.
Project Number
(Proje No:15/085).
References
- Azal Ö. Gestasyonel Diabetes Mellitusun Etyopatogenezi. Turkiye Klinikleri J Endocrin-Special Topics. 2010;3:6-13.
- Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS. Kaiser Permanente of Colorado GDM Screening Program. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth Cohort Kaiser Permanente of Colorado GDM Screening Program. Diabetes Care. 2005;28(3):579-84.
- Ozcimen EE, Uckuyu A, Ciftci FC, Yanik FF, Bakar C. Diagnosis of gestational diabetes mellitus by use of the homeostasis model assessment–insulin resistance index in the first trimester. Gynecological Endocrin. 2008;24(4):224-9.
- American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(1):S81-90.
- Türkiye Endokrinoloji ve Metabolizma Derneği Diabetes Mellitus Çalışma Grubu TEMD Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu 2013, 6.baskı, Bayt Bilimsel Araştırmalar Basın Yayın ve Tanıtım Ltd. Şti. Ankara, 2013, s: 15-193.
- Kuohung W, Kaiser UB. GPR54 and KiSS-1: role in the regulation of puberty and reproduction. Reviews in Endocrine and Metabolic Disorders, Rev Endocr Metab Disord. 2006;7(4):257-63.
- Silvestre RA, Egido EM, Hernández R, Marco J.Kisspeptin-13 inhibits insulin secretion without affecting glucagon or somatostatin release: study in the perfused rat pancreas. J Endocrinol. 2008;196(2):283-90.
- Bowe JE, King AJ, Kinsey-Jones JS, et al. .Kisspeptin stimulation of insulin secretion: mechanisms of action in mouse islets and rats. Diabetologia. 2009;52(5):855-62.
- Matsui H, Takatsu Y, Kumano S, Matsumoto H, Ohtaki T. Peripheral administration of metastin induces marked gonadotropin release and ovulation in the rat. Biochem Biophys Res Commun. 2004;320(2):383-8.
- Terao Y, Kumano S, Takatsu Y, et al. Expression of KiSS-1, a metastasis suppressor gene, in trophoblast giant cells of the rat placenta. Biochim Biophys Acta. 2004;1678(2-3):102-10.
- Horikoshi Y, Matsumoto H, Takatsu Y, et al. .Dramatic elevation of plasma metastin concentrations in human pregnancy: metastin as a novel placenta-derived hormone in humans. J Clin Endocrinol Metab. 2003;88(2):914-9.
- Vidaeff AC, Yeomans ER, Ramin SM. Gestational Diabetes: A Field of Controversy. Obstet Gynecol Surv. 2003;58(11):759-69.
- Coustan DR, Nelson C, Carpenter MW, Carr SR, Rotondo L, Widness JA. Maternal age and screening for gestational diabetes: a population-based study. Obstet Gynecol. 1989;73(4):557-61.
- Aydın M, Gürel A, Çelik C, Tülübaş F, Abalı R, Yılmaz A. Namık Kemal Üniversitesi Araştırma ve Uygulama Hastanesinde Gestasyonel Diyabetes Mellitus Prevalansı. Yeni Tıp Derg. 2013;30(4):252.
- HG Atlı, R Atılgan, H Atlı, A Gürel, S Aydın. Gestasyonel Diyabetes Mellitus Patogenezinde Desnutrin’in Rolü Var mı? Van Tıp Derg. 2015;22(3):144-8.
- Alanbay İ, Çoksüer H, Ercan CM, et al. Gestasyonel diyabetes mellitus olgularında maternal vücut kitle indeksi ve kilo alımı ile maternal biyokimyasal değerler ve fetal doğum ağırlığının karşılaştırılması. Gulhane Med J. 2011; 53(4):237-42.
- Morisset AS, St-Yves A, Veillette J, Weisnagel SJ, Tchernof A, Robitaille J. Prevention of gestational diabetes mellitus: a review of studies on weight management. Diabetes Metab Res Rev. 2010;26(1):17-25.
- Riskin-Mashiah S, Damti A, Younes G, Auslander R. Pregestational body mass index, weight gain during pregnancy and maternal hyperglycemia. Gynecol Endocrinol. 2011;27(7):464-7.
- Tovar A, Must A, Bermudez OI, Hyatt RR, Chasan-Taber L. The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women. Matern Child Health J. 2009;13(4):520-30.
- Van Wootten W, Turner RE. Macrosomia in neonates of mothers with gestational diabetes is associated with body mass index and previous gestational diabetes. J Am Diet Assoc. 2002;102(2):241-3.
- Schaefer-Graf UM, Kjos SL, Kilavuz O, Plagemann A, Brauer M, Dudenhausen JW, et al. Determinants of fetal growth at different periods of pregnancies complicated by gestational diabetes mellitus or impaired glucose tolerance. Diabetes Care. 2003;26(1):193-8.
- Okun N, Verma A, Mitchell BF, Flowerdew G. Relative importance of maternal constitutional factors and glucose intolerance of pregnancy in the development of newborn macrosomia. J Matern Fetal Med. 1997;6(5):285-90.
- Schaefer-Graf UM, Heuer R, Kilavuz O, Pandura A, Henrich W, Vetter K. Maternal obesity not maternal glucose values correlates best with high rates of fetal macrosomia in pregnancies complicated by gestational diabetes. J Perinat Med. 2002;30(4):313-21.
- Ehrenberg HM, Mercer BM, Catalano PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol. 2004;191(3):964-8.
- Gorgal R, Gonçalves E, Barros M, Namora G, Magalhães A, Rodrigues T, Montenegro N. Gestational diabetes mellitus: A risk factor for non‐elective cesarean section. J Obstet Gynaecol Res. 2012;38(1):154-9.
- Şahan MH, Karabay A, Tökmecı Ö. Gestasyonel Diyabette İkinci Trimester Doppler Ultrason Parametrelerinin Karşılaştırılması. Tıp Araştırmaları Derg, 2015, 13.3.
- Brudenell JM. Delivering the baby of the diabetic mother. J R Soc Med. 1978;71(3):207-11.
- Riskin A, Garcia-Prats Ja. Infant of a diabetic mother. Accessed Feb 2016. http://www.uptodate.com/contents/infant-of-a-diabetic-mother
- Sayın NC, Varol FG, Canda T, Duran R, Vatansever Ü. Normoglisemik Gestasyonel Diabetes Mellitus'lu Gebelerde Perinatal Sonu. Turkiye Klinikleri J Gynecol Obst. 2003;13(6):454-9.
- Montoro MN, Kjos SL, Chandler M, Peters RK, Xiang AH, Buchanan TA. Insulin resistance and preeclampsia in gestational diabetes mellitus. Diabetes Care. 2005;28(8):1995-2000.
- Mcintyreb HD. Hyperglycemia and adverse Pregnancy Outcome (HAPO) study: preeclampsia. In: American Journal of Obstetrics and Gynecology. Mosby, 2010. p. 255. e1-255. e7.
- Parretti E, Lapolla A, Dalfrà M, Pacini G, Mari A, Cioni R. Preeclampsia in lean normotensive normotolerant pregnant women can be predicted by simple insulin sensitivity indexes. Hypertension. 2006;47(3):449-53.
- Potter CF, Kicklighter SD. Infant of diabetic mother. Diabetes Care. 2006:100:619–37.
Abstract
Gestasyonel Diyabetes Mellitus, ilk defa gebelikte başlayan veya gebelikte tanı konulan, farklı düzeylerde hiperglisemi ile seyreden glukoz tolerans bozukluğudur. Kisspeptinler, RF-Amid yapıda KİSS-1 geni tarafından kodlanan bir nöropeptid ailesidir. Kisspeptinlerin gebelikte en fazla plasentadan salgılandığı düşünülmektedir. Fizyolojik görevi net olmamakla birlikte büyüme hormonuna benzer davrandığı, trofoblastların implantasyonu ve invazyonunu etkilediği düşünülmektedir. Çalışmamızda; Gestasyonel Diyabetes Mellitus olan ve olmayan gebelerde plazma Kisspeptin-10 düzeyleri karşılaştırılmış ve etyolojide kisspeptinlerin rolü ve Kisspeptin-10 düzeylerinin perinatal sonuçlara etkisi araştırılmıştır. Çalışmaya 25-41. gebelik haftaları arasında olan OGTT ile Gestasyonel diyabet tanısı alan 31 ve sağlıklı 28 gebe kadın dahil edildi. Gönüllülerin plazma kisspeptin düzeyleri araştırıldı. Verilerin istatistiksel analizi SPSS 20.0 istatistik programı ile yapıldı. Student’s t testi, Mann-Whitney U testi ve Pearson Korrelasyon Analizi kullanıldı. p<0.05 istatistiksel olarak anlamlı kabul edildi. Gestasyonel Diyabeti olan hastalar ile kontrol grubundaki hastalar arasında BMI’ları haricinde istatistiksel anlamlı fark tesbit edilmedi. Gestasyonel diyabeti olan gebe kadınlarda insülin ihtiyacı olanlar ve olmayanlar, fetal distressi olanlar ve olmayanlar, yenidoğan yoğun bakım ihtiyacı olanlar ve olmayanlar arasında kisspeptin düzeyleri açısından istatistiksel anlamlı bir farklılık tespit edilmemiştir. Kisspeptin düzeyi ile olguların yaşları arasında pozitif korrelasyon tesbit edildi (R= 0.259, p=0.048). Kisspeptin düzeyi ile alınan kilo arasında negatif korrelasyon tesbit edildi (R=-0.278, p=0.033). Gestasyonel Diyabetes Mellitus etyopatogenezinde kisspeptinin de diğer hormonlar gibi rolü olabilir. Kisspeptinin Gestasyonel Diyabetes Mellitus’ta tanı, tarama testi ve prognostik belirteç olarak kullanılabilmesi için daha geniş çalışmalara ihtiyaç olduğunu düşünmekteyiz.
Supporting Institution
Muğla Sıtkı Koçman Üniversitesi Bilimsel Araştırma Projeleri (BAP) Koordinasyon Birimi tarafından desteklenmiştir (Proje No:15/085).
Project Number
(Proje No:15/085).
References
- Azal Ö. Gestasyonel Diabetes Mellitusun Etyopatogenezi. Turkiye Klinikleri J Endocrin-Special Topics. 2010;3:6-13.
- Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS. Kaiser Permanente of Colorado GDM Screening Program. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth Cohort Kaiser Permanente of Colorado GDM Screening Program. Diabetes Care. 2005;28(3):579-84.
- Ozcimen EE, Uckuyu A, Ciftci FC, Yanik FF, Bakar C. Diagnosis of gestational diabetes mellitus by use of the homeostasis model assessment–insulin resistance index in the first trimester. Gynecological Endocrin. 2008;24(4):224-9.
- American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(1):S81-90.
- Türkiye Endokrinoloji ve Metabolizma Derneği Diabetes Mellitus Çalışma Grubu TEMD Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu 2013, 6.baskı, Bayt Bilimsel Araştırmalar Basın Yayın ve Tanıtım Ltd. Şti. Ankara, 2013, s: 15-193.
- Kuohung W, Kaiser UB. GPR54 and KiSS-1: role in the regulation of puberty and reproduction. Reviews in Endocrine and Metabolic Disorders, Rev Endocr Metab Disord. 2006;7(4):257-63.
- Silvestre RA, Egido EM, Hernández R, Marco J.Kisspeptin-13 inhibits insulin secretion without affecting glucagon or somatostatin release: study in the perfused rat pancreas. J Endocrinol. 2008;196(2):283-90.
- Bowe JE, King AJ, Kinsey-Jones JS, et al. .Kisspeptin stimulation of insulin secretion: mechanisms of action in mouse islets and rats. Diabetologia. 2009;52(5):855-62.
- Matsui H, Takatsu Y, Kumano S, Matsumoto H, Ohtaki T. Peripheral administration of metastin induces marked gonadotropin release and ovulation in the rat. Biochem Biophys Res Commun. 2004;320(2):383-8.
- Terao Y, Kumano S, Takatsu Y, et al. Expression of KiSS-1, a metastasis suppressor gene, in trophoblast giant cells of the rat placenta. Biochim Biophys Acta. 2004;1678(2-3):102-10.
- Horikoshi Y, Matsumoto H, Takatsu Y, et al. .Dramatic elevation of plasma metastin concentrations in human pregnancy: metastin as a novel placenta-derived hormone in humans. J Clin Endocrinol Metab. 2003;88(2):914-9.
- Vidaeff AC, Yeomans ER, Ramin SM. Gestational Diabetes: A Field of Controversy. Obstet Gynecol Surv. 2003;58(11):759-69.
- Coustan DR, Nelson C, Carpenter MW, Carr SR, Rotondo L, Widness JA. Maternal age and screening for gestational diabetes: a population-based study. Obstet Gynecol. 1989;73(4):557-61.
- Aydın M, Gürel A, Çelik C, Tülübaş F, Abalı R, Yılmaz A. Namık Kemal Üniversitesi Araştırma ve Uygulama Hastanesinde Gestasyonel Diyabetes Mellitus Prevalansı. Yeni Tıp Derg. 2013;30(4):252.
- HG Atlı, R Atılgan, H Atlı, A Gürel, S Aydın. Gestasyonel Diyabetes Mellitus Patogenezinde Desnutrin’in Rolü Var mı? Van Tıp Derg. 2015;22(3):144-8.
- Alanbay İ, Çoksüer H, Ercan CM, et al. Gestasyonel diyabetes mellitus olgularında maternal vücut kitle indeksi ve kilo alımı ile maternal biyokimyasal değerler ve fetal doğum ağırlığının karşılaştırılması. Gulhane Med J. 2011; 53(4):237-42.
- Morisset AS, St-Yves A, Veillette J, Weisnagel SJ, Tchernof A, Robitaille J. Prevention of gestational diabetes mellitus: a review of studies on weight management. Diabetes Metab Res Rev. 2010;26(1):17-25.
- Riskin-Mashiah S, Damti A, Younes G, Auslander R. Pregestational body mass index, weight gain during pregnancy and maternal hyperglycemia. Gynecol Endocrinol. 2011;27(7):464-7.
- Tovar A, Must A, Bermudez OI, Hyatt RR, Chasan-Taber L. The impact of gestational weight gain and diet on abnormal glucose tolerance during pregnancy in Hispanic women. Matern Child Health J. 2009;13(4):520-30.
- Van Wootten W, Turner RE. Macrosomia in neonates of mothers with gestational diabetes is associated with body mass index and previous gestational diabetes. J Am Diet Assoc. 2002;102(2):241-3.
- Schaefer-Graf UM, Kjos SL, Kilavuz O, Plagemann A, Brauer M, Dudenhausen JW, et al. Determinants of fetal growth at different periods of pregnancies complicated by gestational diabetes mellitus or impaired glucose tolerance. Diabetes Care. 2003;26(1):193-8.
- Okun N, Verma A, Mitchell BF, Flowerdew G. Relative importance of maternal constitutional factors and glucose intolerance of pregnancy in the development of newborn macrosomia. J Matern Fetal Med. 1997;6(5):285-90.
- Schaefer-Graf UM, Heuer R, Kilavuz O, Pandura A, Henrich W, Vetter K. Maternal obesity not maternal glucose values correlates best with high rates of fetal macrosomia in pregnancies complicated by gestational diabetes. J Perinat Med. 2002;30(4):313-21.
- Ehrenberg HM, Mercer BM, Catalano PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol. 2004;191(3):964-8.
- Gorgal R, Gonçalves E, Barros M, Namora G, Magalhães A, Rodrigues T, Montenegro N. Gestational diabetes mellitus: A risk factor for non‐elective cesarean section. J Obstet Gynaecol Res. 2012;38(1):154-9.
- Şahan MH, Karabay A, Tökmecı Ö. Gestasyonel Diyabette İkinci Trimester Doppler Ultrason Parametrelerinin Karşılaştırılması. Tıp Araştırmaları Derg, 2015, 13.3.
- Brudenell JM. Delivering the baby of the diabetic mother. J R Soc Med. 1978;71(3):207-11.
- Riskin A, Garcia-Prats Ja. Infant of a diabetic mother. Accessed Feb 2016. http://www.uptodate.com/contents/infant-of-a-diabetic-mother
- Sayın NC, Varol FG, Canda T, Duran R, Vatansever Ü. Normoglisemik Gestasyonel Diabetes Mellitus'lu Gebelerde Perinatal Sonu. Turkiye Klinikleri J Gynecol Obst. 2003;13(6):454-9.
- Montoro MN, Kjos SL, Chandler M, Peters RK, Xiang AH, Buchanan TA. Insulin resistance and preeclampsia in gestational diabetes mellitus. Diabetes Care. 2005;28(8):1995-2000.
- Mcintyreb HD. Hyperglycemia and adverse Pregnancy Outcome (HAPO) study: preeclampsia. In: American Journal of Obstetrics and Gynecology. Mosby, 2010. p. 255. e1-255. e7.
- Parretti E, Lapolla A, Dalfrà M, Pacini G, Mari A, Cioni R. Preeclampsia in lean normotensive normotolerant pregnant women can be predicted by simple insulin sensitivity indexes. Hypertension. 2006;47(3):449-53.
- Potter CF, Kicklighter SD. Infant of diabetic mother. Diabetes Care. 2006:100:619–37.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Surgery |
| Journal Section | Original Article |
| Authors | |
| Project Number | (Proje No:15/085). |
| Publication Date | August 31, 2020 |
| Submission Date | May 11, 2020 |
| Published in Issue | Year 2020 Volume: 7 Issue: 2 |
