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Keywords:

  • Inflammation;
  • gestational diabetes;
  • YKL-40

Eur J Clin Invest 2010; 40 (4): 339–343

Abstract

Background  Gestational diabetes (GDM) is an increasing and common complication of pregnancy. The involvement of inflammatory mechanisms in GDM remains unclear. YKL-40 is a novel inflammatory marker that has been recently found to be associated with type 2 diabetes. This is the first study to investigate YKL-40 in GDM.

Material and methods  A total of 58 subjects were included, 28 patients with GDM (BMI 33·2 ± 6·1 kg m, 33 ± 6 years) and 30 healthy pregnant controls (BMI 28·4 ± 5·2 kg m, 33 ± 4 years; mean ± SD). Standard risk factors for GDM (weight and BMI prior to pregnancy, family history, former GDM, high birthweight offspring) were evaluated. A 2-h 75-g oral glucose tolerance test (oGTT) and measurement of YKL-40 were conducted in gestational week 28 ± 4, as well as 8 weeks after delivery.

Results  YKL-40 was not different between GDM and controls, neither during (65·8 ± 44·4 vs. 60·3 ± 30·1 ng mL−1), nor after pregnancy (63·4 ± 30·5 vs. 66·9 ± 32·7 ng mL−1). YKL-40 was correlated with insulin, HOMA and BMI. GDM had higher fasting insulin (14·1 ± 7·4 vs. 8·3 ± 4·3 μU mL−1) and glucose (88 ± 13 – 200 ± 31 – 160 ± 33 vs. 76 ± 10 – 146 ± 37 – 112 ± 28 mg dL−1 for fasting, 1- and 2-h-concentrations in the oGTT, respectively), higher HbA1c (5·3 ± 0·4 vs. 5·0 ± 0·5%;), HOMA (3·1 ± 1·7 vs. 1·6 ± 0·9), and BMI (33·2 ± 6·1 vs. 28·5 ± 5·2 kg m−2) (means ± SD, all < 0·01).

Conclusions  No difference in YKL-40 between GDM and controls suggests similar inflammatory status at the time of measurements. The short duration of metabolic changes during GDM might explain this finding, which is in contrast to results in type 2 diabetes.