Gestational diabetes mellitus (GDM) and preeclampsia (PE) are both characterized by endothelial d... more Gestational diabetes mellitus (GDM) and preeclampsia (PE) are both characterized by endothelial dysfunction and GDM women have higher incidence of PE. The placenta plays a key role in PE pathogenesis but its contribution to PE during GDM remains unclear. Herein, we compared placental and maternal blood anti-angiogenic soluble fms-like tyrosine kinase-1 (sFlt1) and pro-angiogenic Placental Growth Factor (PlGF) expressions in GDM and GDM-PE pregnancies compared to controls (CTRL) and PE cases. Electrochemiluminescence immunoassays showed a significantly higher maternal blood sFlt1/PlGF values in GDM-PE relative to CTRL and GDM pregnancies. We reported that placental PlGF gene expression was significantly decreased in GDM, PE and GDM-PE relative to CTRL. However, PlGF protein levels were significantly increased in GDM and GDM-PE relative to CTRL and PE placentae. Finally, sFlt1 gene expression was significantly increased in PE relative to CTRL, GDM and GDM-PE placentae. In contrast, sF...
Leptin is a proteic hormone, isolated in 1994, mainly synthetized in the white adipose tissue. Ai... more Leptin is a proteic hormone, isolated in 1994, mainly synthetized in the white adipose tissue. Aim of this study was to compare leptin concentrations in normal pregnancies with those measured in pregnancies complicated by gestational diabetes or gestational hypertension or pre-eclampsia. We enrolled 48 pregnant women: 18 with uncomplicated pregnancy, 11 with gestational diabetes, 19 with gestational hypertension or pre-eclampsia. Leptin concentrations were measured in maternal serum at enrollment, together with insulin and cortisol, at delivery and in the immediate postpartum. At delivery serum leptin was calculated in the cord blood too. Fasting plasma leptin and insulin were higher in the group of patients with gestational hypertension, than in the other groups. Third-trimester maternal leptin concentrations correlated significantly with insulin levels in the group of women with gestational diabetes and in the group with gestational hypertension or pre-eclampsia, but not in the wo...
ABSTRACT As reported by other workers, late pregnancy is accompanied by an insulin-resistant stat... more ABSTRACT As reported by other workers, late pregnancy is accompanied by an insulin-resistant state, which is not clearly explained by rising of the so-called gestational hormones. The present study reports the results on insulin binding and insulin action on adipocytes from healthy, obese and diabetic pregnant women (17 s.) isolated during Caesarian section and in control non pregnant women (22 s.). Glucose intolerance with hyperinsulinemia was shown in our healthy pregnant women but it was more evident in the obese pregnant women. Adipose cells' volume was larger than in non-pregnant state both in healthy and obese and diabetic pregnant women. Binding data, normalized to the same insulin concentration and cells number, indicated a decrease to the half of high affinity receptor sites with a slight decrease of total receptor numbers in healthy pregnant women; the obese and diabetic pregnant women showed a greater decrease in both affinity constants and receptor numbers. These data suggest that during pregnancy a decrease in receptor numbers and affinity constants takes place and is more evident in obese and diabetic pregnant women, giving a peripheral explanation to the insulin resistance itself. In this sense biological activity of isolated adipocytes gave a partial confirmation: glycerol release-inhibition in the presence of increasing amounts of insulin was decreased in obese and diabetic pregnant women in comparison with healthy pregnant women, but glucose-U- 14C incorporation into adipose glycogen did not differ in the 3 groups. Because plasma insulin increases during pregnancy, the hypothesis of a down regulation of insulin-receptor by circulating insulin is confirmed by this research.
Ovarian hyperstimulation syndrome (OHSS) is rather frequent (1-5%) in women submitted to superovu... more Ovarian hyperstimulation syndrome (OHSS) is rather frequent (1-5%) in women submitted to superovulation with gonadotropins for in vitro fertilisation (IVF), whereas it is very rare in case of spontaneous ovulation. Spontaneous OHSS (sOHSS) was previously described to be associated to hydatiform mole, multiple conception, hypothyroidism in pregnancy. It may also depend on activating mutations of the FSH receptor (FSHR) gene that cause ovarian hyper-responsiveness to circulating FSH or even cross-responsiveness of FSHR to hormones having a structure similar to FSH, such as hCG or TSH. We report, herein, a case of sOHSS in a woman who conceived spontaneously. We checked the presence of all possible factors that could explain the onset of the syndrome, and we evidenced hypothyroidism and abnormally elevated hCG levels in the second trimester of pregnancy. The thorough molecular biology study of FSHR gene did not detect exonic mutations, but revealed the presence of intronic mutations whose role in the onset of sOHSS is still uncertain.
Paired capillary-venous blood samples were obtained from 418 pregnant women undergoing an oral gl... more Paired capillary-venous blood samples were obtained from 418 pregnant women undergoing an oral glucose challenge test (GCT) for the screening of gestational diabetes (GD). The relationship between capillary and plasma glucose concentrations was investigated in order to establish a capillary GCT threshold. Plasma glucose was assayed by the glucose oxidase method and capillary glucose using Reflocheck Glucose strips and a Reflocheck reflectance meter. During GCT the capillary values exceeded plasma glucose values by a mean difference of 10-12 mg/dl fasting and 22-24 mg/dl after 1 h. A high correlation between the glucose values of the two techniques was found, particularly for those at 1 h, with corresponding capillary determinations being 20 mg/dl above plasma values. The sensitivity, specificity and predictive value of the various capillary thresholds investigated in detecting GD corresponded substantially to the accuracy of plasma thresholds 20 mg/dl lower. The receiver operator characteristic curves of the plasma and capillary thresholds were similar in shape and the optimal cut-off point for performing a diagnostic test was set at 135 and 155 mg/dl, respectively. These cut-off values should be reconsidered in the light of the costs and perinatal outcome.
Gestational diabetes mellitus (GDM) and preeclampsia (PE) are both characterized by endothelial d... more Gestational diabetes mellitus (GDM) and preeclampsia (PE) are both characterized by endothelial dysfunction and GDM women have higher incidence of PE. The placenta plays a key role in PE pathogenesis but its contribution to PE during GDM remains unclear. Herein, we compared placental and maternal blood anti-angiogenic soluble fms-like tyrosine kinase-1 (sFlt1) and pro-angiogenic Placental Growth Factor (PlGF) expressions in GDM and GDM-PE pregnancies compared to controls (CTRL) and PE cases. Electrochemiluminescence immunoassays showed a significantly higher maternal blood sFlt1/PlGF values in GDM-PE relative to CTRL and GDM pregnancies. We reported that placental PlGF gene expression was significantly decreased in GDM, PE and GDM-PE relative to CTRL. However, PlGF protein levels were significantly increased in GDM and GDM-PE relative to CTRL and PE placentae. Finally, sFlt1 gene expression was significantly increased in PE relative to CTRL, GDM and GDM-PE placentae. In contrast, sF...
Leptin is a proteic hormone, isolated in 1994, mainly synthetized in the white adipose tissue. Ai... more Leptin is a proteic hormone, isolated in 1994, mainly synthetized in the white adipose tissue. Aim of this study was to compare leptin concentrations in normal pregnancies with those measured in pregnancies complicated by gestational diabetes or gestational hypertension or pre-eclampsia. We enrolled 48 pregnant women: 18 with uncomplicated pregnancy, 11 with gestational diabetes, 19 with gestational hypertension or pre-eclampsia. Leptin concentrations were measured in maternal serum at enrollment, together with insulin and cortisol, at delivery and in the immediate postpartum. At delivery serum leptin was calculated in the cord blood too. Fasting plasma leptin and insulin were higher in the group of patients with gestational hypertension, than in the other groups. Third-trimester maternal leptin concentrations correlated significantly with insulin levels in the group of women with gestational diabetes and in the group with gestational hypertension or pre-eclampsia, but not in the wo...
ABSTRACT As reported by other workers, late pregnancy is accompanied by an insulin-resistant stat... more ABSTRACT As reported by other workers, late pregnancy is accompanied by an insulin-resistant state, which is not clearly explained by rising of the so-called gestational hormones. The present study reports the results on insulin binding and insulin action on adipocytes from healthy, obese and diabetic pregnant women (17 s.) isolated during Caesarian section and in control non pregnant women (22 s.). Glucose intolerance with hyperinsulinemia was shown in our healthy pregnant women but it was more evident in the obese pregnant women. Adipose cells' volume was larger than in non-pregnant state both in healthy and obese and diabetic pregnant women. Binding data, normalized to the same insulin concentration and cells number, indicated a decrease to the half of high affinity receptor sites with a slight decrease of total receptor numbers in healthy pregnant women; the obese and diabetic pregnant women showed a greater decrease in both affinity constants and receptor numbers. These data suggest that during pregnancy a decrease in receptor numbers and affinity constants takes place and is more evident in obese and diabetic pregnant women, giving a peripheral explanation to the insulin resistance itself. In this sense biological activity of isolated adipocytes gave a partial confirmation: glycerol release-inhibition in the presence of increasing amounts of insulin was decreased in obese and diabetic pregnant women in comparison with healthy pregnant women, but glucose-U- 14C incorporation into adipose glycogen did not differ in the 3 groups. Because plasma insulin increases during pregnancy, the hypothesis of a down regulation of insulin-receptor by circulating insulin is confirmed by this research.
Ovarian hyperstimulation syndrome (OHSS) is rather frequent (1-5%) in women submitted to superovu... more Ovarian hyperstimulation syndrome (OHSS) is rather frequent (1-5%) in women submitted to superovulation with gonadotropins for in vitro fertilisation (IVF), whereas it is very rare in case of spontaneous ovulation. Spontaneous OHSS (sOHSS) was previously described to be associated to hydatiform mole, multiple conception, hypothyroidism in pregnancy. It may also depend on activating mutations of the FSH receptor (FSHR) gene that cause ovarian hyper-responsiveness to circulating FSH or even cross-responsiveness of FSHR to hormones having a structure similar to FSH, such as hCG or TSH. We report, herein, a case of sOHSS in a woman who conceived spontaneously. We checked the presence of all possible factors that could explain the onset of the syndrome, and we evidenced hypothyroidism and abnormally elevated hCG levels in the second trimester of pregnancy. The thorough molecular biology study of FSHR gene did not detect exonic mutations, but revealed the presence of intronic mutations whose role in the onset of sOHSS is still uncertain.
Paired capillary-venous blood samples were obtained from 418 pregnant women undergoing an oral gl... more Paired capillary-venous blood samples were obtained from 418 pregnant women undergoing an oral glucose challenge test (GCT) for the screening of gestational diabetes (GD). The relationship between capillary and plasma glucose concentrations was investigated in order to establish a capillary GCT threshold. Plasma glucose was assayed by the glucose oxidase method and capillary glucose using Reflocheck Glucose strips and a Reflocheck reflectance meter. During GCT the capillary values exceeded plasma glucose values by a mean difference of 10-12 mg/dl fasting and 22-24 mg/dl after 1 h. A high correlation between the glucose values of the two techniques was found, particularly for those at 1 h, with corresponding capillary determinations being 20 mg/dl above plasma values. The sensitivity, specificity and predictive value of the various capillary thresholds investigated in detecting GD corresponded substantially to the accuracy of plasma thresholds 20 mg/dl lower. The receiver operator characteristic curves of the plasma and capillary thresholds were similar in shape and the optimal cut-off point for performing a diagnostic test was set at 135 and 155 mg/dl, respectively. These cut-off values should be reconsidered in the light of the costs and perinatal outcome.
Uploads
Papers by G. Menato