Troponin T and pro-B-type natriuretic Peptide in fetuses of type 1 diabetic mothers.

Abstract:

OBJECTIVE:Cardiomyopathy is noted in up to 40% of infants of diabetic mothers, and the exact mechanisms are unknown. The aim of this study was to determine whether fetal serum markers of cardiac function differ between normal and type 1 diabetic pregnancies and to examine the relationship between these markers and fetal cardiac structure and function. RESEARCH DESIGN AND METHODS:This was a prospective observational study of 45 type 1 diabetic pregnancies and 39 normal pregnancies. All participants had concentrations of fetal pro-B-type natriuretic peptide (proBNP) and troponin-T (TnT) measured at the time of delivery. All patients with type 1 diabetes had Doppler evaluation of the umbilical artery, middle cerebral artery, and ductus venosus in the third trimester, and a subset (n = 21) had detailed fetal echocardiograms performed in each trimester. RESULTS:Fetal proBNP and TnT concentrations were higher in the diabetic cohort than in the normal cohort (P < 0.05). ProBNP correlated positively with interventricular septum thickness (P < 0.05) but not with cardiac function indexes in the third trimester. In patients with poor glycemic control, there was a significant positive correlation (P < 0.05) between fetal TnT and the third trimester umbilical artery pulsatility index. There were also increased levels of fetal TnT in infants with poor perinatal outcome (P < 0.05). CONCLUSIONS:Biochemical markers of cardiac dysfunction are elevated in infants of diabetic mothers, especially those with cardiomyopathy or poor perinatal outcome. Hyperglycemia in early pregnancy may affect myocardial and placental development, thus contributing to the susceptibility to hypoxia seen in these infants.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Russell NE,Higgins MF,Amaruso M,Foley M,McAuliffe FM

doi

10.2337/dc09-0552

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

2050-5

issue

11

eissn

0149-5992

issn

1935-5548

pii

dc09-0552

journal_volume

32

pub_type

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    journal_title:Diabetes care

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    pub_type: 杂志文章,多中心研究

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    pub_type: 杂志文章,随机对照试验

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    pub_type: 杂志文章

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    pub_type: 临床试验,杂志文章,随机对照试验

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  • Determinants of racial/ethnic disparities in incidence of diabetes in postmenopausal women in the U.S.: The Women's Health Initiative 1993-2009.

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  • Insulin-based versus triple oral therapy for newly diagnosed type 2 diabetes: which is better?

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    journal_title:Diabetes care

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    pub_type: 杂志文章

    doi:10.2337/dc13-1012

    authors: Yoo JY,Lee S,Lee HA,Park H,Park YJ,Ha EH,Kim YJ

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  • Apolipoprotein E polymorphism as a risk factor for vascular disease in diabetic patients.

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    pub_type: 杂志文章

    doi:10.2337/diacare.18.4.504

    authors: Boemi M,Sirolla C,Amadio L,Fumelli P,Pometta D,James RW

    更新日期:1995-04-01 00:00:00