| Abstract | Cilj: Gestacijski dijabetes (GD) definiran je kao hiperglikemija koja se prepoznaje prvi puta
tijekom trudnoće, a njegova je incidencija u porastu. Cilj istraživanja bio je ispitati razlike u
omjerima imunoloških stanica (NKT/NK-stanica, B1/B2-limfocita, pomagačkih/citotoksičnih Tlimfocita) između trudnica s GD-om i zdravih trudnica te odrediti razinu proupalnih i
protuupalnih biljega (IL-6, TNF-α, IL-10, adiponektin) i njihove genske varijante povezane s
imunološkim odgovorom te usporediti rezultate s rutinskim biokemijskim i hematološkim
parametrima.
Nacrt studije: Istraživanje je ustrojeno kao presječno istraživanje te je u njemu sudjelovalo 162
trudnice u trećem trimestru trudnoće. Ispitanice su podijeljene u 4 skupine: trudnice s GD-om
bez komplikacija, trudnice s GD-om i dodatnim komplikacijama, kontrolna skupina trudnica
(koje nisu razvile GD) bez komplikacija i kontrolna skupina trudnica (trudnice koje nisu razvile
GD) s komplikacijama.
Ispitanici i metode: Venska je krv uzorkovana trudnicama u trećem trimestru trudnoće te su
učinjene analize koje su obuhvatile određivanje kompletne krvne slike i diferencijalne krvne
slike, glukozu, lipide, C-reaktivni protein, imunoglobuline, hormone (inzulin, C-peptid), vitamine
(B12, folna kiselina), NT-proBNP, željezo, feritin, HbA1c, interleukin (IL)-6, IL-10, TNF-α,
adiponektin, imunofenotipizaciju limfocita protočnom citometrijom i genotipizacija varijanti
gena rs266729 (AdipoQ), rs1800629 (TNF-α), rs1800896 (IL-10) i rs1800796 (IL-6) metodom
lančane reakcije polimeraze u stvarnom vremenu.
Rezultati: Nema statistički značajne razlike u omjerima NKT/NK-stanica, B1/B2-limfocita i
pomagačkih/citotoksičnih limfocita između trudnica s GD-om i zdravih trudnica, međutim kod
trudnica s GD-om omjer je B1/B2-limfocita bio niži kod visokih vrijednosti IL-6 te u značajnoj
negativnoj vezi s adiponektinom. Različiti omjeri imunoloških stanica bili su povezani s drugim
biokemijskim parametrima, poput lipida i hormona. Određene genske varijante (SNP)
povezane su s povećanim rizikom od razvoja GD-a. Genotip CG u rs1800769 u genu za IL-6 i
genotip CC u rs266729 u genu AdipoQ pokazali su se čimbenicima rizika za razvoj GD-a. Nisu
pronađene značajne povezanosti između ispitivanih genotipova i izmjerenih koncentracija
adiponektina, IL-6, IL-10 i TNF-α.
Zaključak: Genotip CG u rs1800769 u genu za IL-6 i genotip CC u rs266729 u genu AdipoQ
povezani su s rizikom za razvoj GD-a, a omjer B1/B2-limfocita u značajnoj je vezi s
vrijednostima adiponektina kod trudnica s GD-om. |
| Abstract (english) | Objective: Gestational diabetes (GD) is defined as hyperglycemia that is recognized for the
first time during pregnancy, and its incidence is increasing. The aim of the research was to
examine the differences in the ratios of immune cells (NKT/NK-cells, B1/B2-lymphocytes,
helper/cytotoxic T-lymphocytes) between pregnant women with GD and healthy pregnant
women, and to determine the level of pro-inflammatory and anti-inflammatory markers (IL-6 ,
TNF-α, IL-10, adiponectin) and their genetic variants associated with the immune response,
and also compare the results with routine biochemical and hematological parameters.
Study draft: The research was organized as a cross-sectional study, and 162 pregnant women
in the third trimester participated in the research. The test subjects were divided into 4 groups:
pregnant women with GD without complications, pregnant women with GD and additional
complications, a control group of pregnant women (who did not develop GD) without
complications and a control group of pregnant women (pregnant women who did not develop
GD) with complications.
Subjects and methods: Venous blood was sampled from pregnant women in the third trimester
of pregnancy and analyzes were performed that included determination of complete blood
count and differential blood count, glucose, lipids, C-reactive protein, immunoglobulins,
hormones (insulin, C-peptide), vitamins (B12, folic acid), NT-proBNP, iron, ferritin, HbA1c,
interleukin (IL)-6, IL-10, TNF-α, adiponectin, immunophenotyping of lymphocytes by flow
cytometry and genotyping of polymorphisms rs266729 (AdipoQ), rs1800629 (TNF-α),
rs1800896 (IL-10) and rs1800796 (IL-6) by the polymerase chain reaction method.
Results: There is no statistically significant difference in the ratios of NKT/NK-cells, B1/B2-
lymphocytes and helper/cytotoxic lymphocytes between pregnant women with GD and healthy
pregnant women, however, in pregnant women with GD, the ratio of B1/B2-lymphocytes was
lower with high values of IL-6 and in a significantly negative relationship with adiponectin.
Different ratios of immune cells were associated with other biochemical parameters, such as
lipids and hormones. Single nucleotide polymorphisms (SNPs) are associated with an
increased risk of developing GD. The CG genotype in rs1800769 in the IL-6 gene and the CC
genotype in rs266729 in the AdipoQ gene were shown to be risk factors for the development
of GD. No significant associations were found between the genotypes for adiponectin, IL-6, IL10 and TNF-α and the measured concentrations of these cytokines.
Conclusion: The CG genotype in rs1800769 in the IL-6 gene and the CC genotype in rs266729
in the AdipoQ gene are associated with the risk of developing GD, and the ratio of B1/B2-
lymphocytes is significantly related to adiponectin values in pregnant women with GD. |
