An immunological and genetic study of patients with gestational diabetes mellitus.

The aim of the study was to evaluate the frequency of islet cell (ICA) and insulin (IAA) antibodies and of HLA antigen typing in a group of subjects diagnosed with gestational diabetes mellitus (GDM) in a screening-diagnostic program during pregnancy. ICA, complement-fixing (CF) ICA and other autoantibodies, absolute number and percentage of lymphocyte subpopulations, and HLA antigens were evaluated in 68 women with GDM and compared with those of matched controls. ICA were found in 2 (2.9%) and IAA in 1 (1.5%). Both ICA-positive women had CF-ICA; one of them was receiving insulin therapy. while the other was on a special diet. No correlations were found between ICA and IAA, nor between IAA and insulin treatment. As far as lymphocyte subsets were concerned, we found a significant increase in the absolute number of total and activated (CD3+HLA-DR+) T lymphocytes and a significant increase in the absolute number and percentage of suppressor/cytotoxic T lymphocytes (CD8) and NK lymphocytes (CD57) in GDM patients compared with normal pregnant controls. Concerning frequency for HLA A, B, C, DR antigens in the GDM population, only Cw7 was found to be significantly increased and A10 significantly decreased in comparison with controls. Our study suggests that GDM is a heterogeneous disorder in which few patients present with the immunologic and genetic markers of type 1 diabetes.

Gender-dependent variability of signal-averaged electrocardiogram in acromegaly.

Ventricular late potentials are obtained by signal-averaged surface electrocardiography. Late potentials in normal subjects may be influenced by physiological elements such as gender, height and body mass index. Considering that growth hormone (GH) hypersecretion is able to markedly alter different anthropometric variables, we studied the relation between these elements and the late potentials of 22 acromegalic patients. Males registered higher absolute QRS duration and LAS40 (low-amplitude signal) and, on the opposite, lower RMS40 (root mean square) in comparison to females; QRS duration and LAS40 seem to depend, however, on the different anthropometric variables, since their normalization with height and lean body mass (LBM) abolishes gender-dependent differences. On the contrary, the persistence, among males, of lower RMS40 in respect to females even after normalization for height, LBM and insulin-like growth factor 1 values makes it likely that the latter ECG variable is independent of the anthropometric ones and from the disease's activity. Moreover, males appear to be more vulnerable to GH heart-harming activity.