Clinical and genetic predictors of preeclampsia in the presence of gestational diabetes mellitus

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AIM OF STUDY

Comprehensive analysis of clinical and genetic predictors of preeclampsia (PE) in the presence of gestational diabetes mellitus (GDM).

MATERIAL AND METHODS

Prospective cohort controlled study (n=118); the 1st group consisted of 68 pregnant women with GDM and PE, the 2nd group — 50 pregnant women with GDM without PE. We held a molecular genetic study of polymorphisms of genes — blood pressure (BP) regulators using the polymerase chain reaction (PCR) method of 7 polymorphic variants of 5 genes responsible for the regulation of components of the renin-angiotensin system and the development of endothelial dysfunction: 704 T>C and 521 C>T in the gene AGT; 1166 A>C in the AGTR1 gene; 1675 G>A in the AGTR2 gene; 825 C>T in the GNB3 gene; 786 T>C and 894 G>T in the NOS3 gene.

RESULTS

Patients with GDM and PE were older and had a higher body mass index (BMI) than women without PE. Obesity was more often detected in patients with PE (70.6% versus 32.0%; p<0.05). Complicated heredity for cardiovascular pathology and diabetes mellitus in the 1st group was more common than in the 2nd group (70.6% and 66.2% versus 50.0% and 28.0%, respectively; p<0.05). GDM was detected in women with PE at an earlier stage of pregnancy than without PE (I trimester: 44.1% versus 24.0%, p=0.045; II trimester: 27.9% versus 14.0%, p=0.012; III trimester: 27.9% versus 62.0%, p=0.041). Results of genotyping of polymorphic markers of renin-angiotensin system dysfunction and endothelial dysfunction showed the significance of polymorphisms 704T>C and 521C>T of the AGT gene, 1166A>C of the AGTR1 gene for the risk of developing PE in women with GDM.

CONCLUSIONS

Clinical and genetic predictors of PE against the background of GDM are age, increased body mass index, heredity burdened by cardiovascular pathology and diabetes mellitus, development of GDM in early pregnancy and carriage in the genotype such genes as AGT 704 T>C, AGT 521 C>T, AGTR1 1166 A>C, AGTR2 1675 G>A, NOS3 786 T>C, NOS3 894 G>T.

Keywords:

gestational diabetes mellitus

preeclampsia

genetic polymorphism

angiotensinogen gene

angiotensin II receptor type 1 gene

angiotensin II receptor type 2 gene

G-protein subunit of GNB3-β3 gene

endothelial NO synthase gene

Authors:

Putilova T.A.

Ural Research Institute of Maternity and Infancy

Deryabina E.G.

Ural Research Institute for Maternal and Child Care

ORCID: 0000-0001-8955-5085

Tretyakova T.B.

Ural Research Institute of Maternity and Infancy

SPIN RSCI: 8626-2640
Scopus AuthorID: 57191620822
ORCID: 0000-0002-5715-7514

Received:

17.03.2020

Accepted:

14.05.2020

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