Data from: Serum levels of endothelial glycocalyx constituents in women at 20 weeks’ gestation who later develop gestational diabetes mellitus compared to matched controls: a pilot study

Objectives: The aim of this pilot study was to determine the serum concentration of heparan sulfate, hyaluronan, chondroitin sulfate, and syndecan-1 and if these serum concentrations can be used to identify women at 20 weeks’ gestation who later develop GDM. Design: Nested case-control study from Auckland New Zealand participants in the prospective cohort Screening for Pregnancy Endpoints study. Setting: Auckland, New Zealand. Participants: Twenty pregnant women (70% European, 15% Indian, 10% Asian, 5% Pacific Islander) at 20 weeks’ gestation without any hypertensive complications who developed GDM by existing New Zealand criteria defined as a fasting glucose > 5.5mmol/L and/or 2h > 9.0 mmol/L after a 75g Oral Glucose Tolerance Test. Women not meeting these criteria were excluded from this study. The GDM subjects were matched with 20 woman who had uncomplicated pregnancies and negative screening for GDM and matched for ethnicity, maternal age, and, BMI. Primary and secondary outcome measures: The primary measures were the serum concentrations of syndecan-1, heparan sulfate, hyaluronan, and chondroitin sulfate determined by quantitative enzyme linked immunosorbent assay. No secondary outcome measures. Results: Binary logistic regression was performed to determine if serum concentrations of EGL constituents in women at 20-weeks’ gestation would be useful in predicting the subsequent diagnosis of GDM. The model was not statistically significant χ2 = 12.5, df = 8, p = .13, which indicates the model was unable to distinguish between pregnant women at 20-weeks’ gestation who later developed GDM and those who did not. Conclusions: Serum concentrations of syndecan-1, heparan sulfate, hyaluronan, and chondroitin sulfate in pregnant women at 20 weeks’ gestation were not associated with later development of GDM. To further explore whether there is any relationship between endothelial glycocalyx constituents and GDM the next step is to evaluate serum concentrations at the time diagnosis of GDM.

研究目的：本先导性研究旨在检测硫酸乙酰肝素、透明质酸、硫酸软骨素以及多配体蛋白聚糖-1（syndecan-1）的血清浓度，并探究上述血清标志物能否用于识别妊娠20周后罹患妊娠糖尿病（Gestational Diabetes Mellitus, GDM）的孕妇。
研究设计：基于新西兰奥克兰市参与前瞻性队列研究《妊娠终点筛查（Screening for Pregnancy Endpoints）》的受试者开展的巢式病例对照研究。
研究地点：新西兰奥克兰。
研究对象：共40名妊娠20周的孕妇，其中70%为欧洲裔、15%为印度裔、10%为亚裔、5%为太平洋岛民；所有受试者均无高血压并发症，且后续按照新西兰现行标准确诊为妊娠糖尿病，诊断标准为：75g口服葡萄糖耐量试验（Oral Glucose Tolerance Test, OGTT）后空腹血糖＞5.5mmol/L和/或2小时血糖＞9.0mmol/L。不符合上述诊断标准的孕妇被排除本研究。妊娠糖尿病病例组与20名妊娠过程无并发症、妊娠糖尿病筛查结果阴性的孕妇进行匹配，匹配因素包括种族、产妇年龄及体质量指数（Body Mass Index, BMI）。
主要与次要结局指标：主要结局指标为采用定量酶联免疫吸附试验（Enzyme Linked Immunosorbent Assay, ELISA）检测的血清多配体蛋白聚糖-1、硫酸乙酰肝素、透明质酸及硫酸软骨素浓度。本研究无次要结局指标。
结果：采用二元logistic回归分析，探究妊娠20周孕妇的内皮糖萼（Endothelial Glycocalyx, EGL）组分血清浓度能否用于预测后续妊娠糖尿病的确诊情况。模型无统计学显著性（χ²=12.5，df=8，P=0.13），提示该模型无法区分妊娠20周后罹患妊娠糖尿病与未罹患该病的孕妇。
结论：妊娠20周孕妇血清中的多配体蛋白聚糖-1、硫酸乙酰肝素、透明质酸及硫酸软骨素浓度与后续妊娠糖尿病的发生无关联。为进一步探究内皮糖萼组分与妊娠糖尿病之间是否存在关联，下一步应在妊娠糖尿病确诊时检测其血清浓度。