Circulating extracellular vesicles during pregnancy in women with type 1 diabetes: a secondary analysis of the CONCEPTT trial

Biomarker Research

on behalf of the CONCEPTT Collaborative Group¹  Dylan Burger²  Akram Abolbaghaei²  Marc-André Langlois³  Denice S. Feig⁴  Helen R Murphy⁵ 

[1] ;Chronic Disease Program, Kidney Research Centre, Ottawa Hospital Research Institute;Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa;Department of Medicine, University of Toronto;Department of Women and Children’s Health, St Thomas’ Hospital, King’s College London;

关键词: Extracellular vesicle;    Type 1 diabetes;    Pregnancy;    Endothelial;    Platelet;    Microparticle;   

DOI  :  10.1186/s40364-021-00322-8

来源: DOAJ

【 摘 要 】

Abstract Background Extracellular vesicles are membrane vesicles that are released into the extracellular environment and accumulate in the circulation in vascular disease. We aimed to quantify circulating extracellular vesicles in pregnant women with type 1 diabetes and to examine associations between extracellular vesicle levels, continuous glucose measures, and pregnancy outcomes. Methods We used plasma samples from the Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial study and quantified circulating extracellular vesicles by flow cytometry (n = 163). Relationships with clinical variables were assessed by repeated measures correlation. Logistic regression was used to assess associations between elevated extracellular vesicle levels and pregnancy outcomes. Results Platelet extracellular vesicle levels were inversely associated with glucose time above range and glycaemic variability measures (P < 0.05). A weak positive association was observed between endothelial extracellular vesicles and mean amplitude of glycemic excursion (P < 0.05). In a univariate logistic regression model, high baseline endothelial extracellular vesicles was associated with increased risk of neonatal intensive care unit (NICU) admission (OR: 2.06, 1.03–4.10), and respiratory distress requiring ventilation (OR: 4.98, 1.04–23.92). After adjusting for HbA1c and blood pressure the relationship for NICU admission persisted and an association with hyperbilirubinemia was seen (OR: 2.56, 1.10–5.94). Elevated platelet extracellular vesicles were associated with an increased risk of NICU admission (OR: 2.18, 1.04–4.57), and hyperbilirubinemia (OR: 2.61, 1.11–6.12) after adjusting for HbA1c and blood pressure. Conclusions High levels of extracellular vesicles in early pregnancy were associated with adverse neonatal outcomes. Assessment of extracellular vesicles may represent a novel approach to personalized care in type 1 diabetes pregnancy.

【 授权许可】

Unknown