Relationship Between Genetic Variant Of OXTR (Rs53576) And MTNR1B (Rs1387153) And Symptoms Of Psychological Stress In Females With Gestational Diabetes Mellitus.

Objective: To assess the association of oxytocin receptor (rs53576) and melatonin hormone receptor 1B (rs1387153) gene single nucleotide polymorphisms with psychological symptoms in women with gestational diabetes mellitus. METHODS: The case-control study was conducted from May 1 to June 1, 2022, at the Department of Physiology, University of Karachi, in collaboration with the Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, and the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi. Fifty gestational diabetic pregnant women and ninety healthy pregnant women were recruited. Sanger sequencing was performed to assess the genotypic frequency and polymorphic variation of all subjects. Perceived stress scale and diabetes-related distress scale were used to assess the stress levels. Data was analysed using SPSS 23. RESULTS: Of the 140 subjects, 90 (64.3%) were controls with mean age 24.96±4.35 years, and 50 (35.7%) were cases with mean age 28.78±5.25 (p<0.05). Mean body weight and mean gestational age were not significantly different between the groups (p>0.05). Melatonin hormone receptor 1B rs1387153 frequency was significantly different between the groups (p<0.05). Among the cases, a significant mean difference for regimen distress scores between AA and GG was observed for oxytocin receptor rs53576 (p=0.04). A significant mean difference in sum of PSS, diabetes-related stress, total diabetes- related stress and emotional distress was noted between CC and TT genotypes for melatonin hormone receptor 1B rs1387153 (p=0.001). Conclusion: MTNR1B rs1387153 genotypes were associated with perceived stress, diabetes-related stress, diabetic distress, and emotional burden, while OXTR rs53576 genotypes were associated with regimen distress in GDM women.

Association of resolvin level in pregnant women with preeclampsia and metabolic syndrome.

OBJECTIVE: Preeclampsia (PE) and Metabolic syndrome (MetS) are multifactorial conditions and are major causes of maternal and neonatal morbidity and mortality worldwide. Both conditions are pro-inflammatory and can be causative factor for vascular damage. Anti-inflammatory mediators such as Resolvin also called resolution-phase interaction products may help to reduce the effect. Therefore, this study aimed to measure the serum Resolvin level in mild pre-eclamptic women with and without metabolic syndrome. MATERIAL AND METHODS: A total of 293 pregnant females were recruited in this case control study. They were grouped as: Group A [pre-eclamptic patients with MetS (n = 140)] and Group B [pre-eclamptic patients without MetS (n = 153)]. Preeclampsia was diagnosed according to the ACOG criteria and metabolic syndrome according the NCEP-ATP III guidelines. Anthropometric data, lipid profile, Resolvin, VEGFR and PlGF levels were tested as per manufacturer's guidelines. Data was analyzed by using SPSS version 23. In all instances, a p value of <0.05 was considered significant. RESULTS: All females were aged matched so no difference was observed in any group. Blood pressure and triglyceride levels were significantly higher in Group A; whereas VEGFR and PlGF were lower as compared to Group B. Higher Resolvin levels were observed in Group A subjects as compared to Group B [105.19 ± 42.29 pg/ml; 46.74 ± 20.16 pg/ml; p < 0.01 respectively]. Resolvin levels were found to have a weak correlation with BMI (r = 0.264; p = 0.11), while a positive strong correlation with systolic BP (r = 0.722; p < 0.001), diastolic BP (r = 0.664; p < 0.001) and a negative correlation with VEGFR (r = -0.639; p < 0.01) and PlGF (r = -0.523; p < 0.01). CONCLUSION: Higher resolvin levels were observed in PE subjects with metabolic syndrome and showed a significant strong positive correlation with blood pressure. Further longitudinal studies are required to identify the causal link.

Association of vitamin D levels with preeclampsia.

OBJECTIVE: This study was aimed to assess maternal vitamin D status during pregnancy and determine the association between maternal 25(OH) D levels with risk of preeclampsia (PE). METHODS: A cross-sectional study was conducted with 172 pregnant women recruited from JPMC between January and December 2017 who were divided as normotensive (n=80) and pre eclamptic (n=92) groups. Blood pressure was recorded at 20 and 32 weeks of gestation. Five ml of blood sample was collected at 20 weeks of gestation to assess the vitamin D levels by commercially available ELISA assay. RESULTS: PE group had a significantly higher systolic (p<0.001) and diastolic (p<0.001) blood pressure at 20 weeks of gestation. Vitamin D levels were reported to be significantly lower (p<0.001) in the PE group (17.97±9.38 ng/ml) as compared to normotensive group (42.18±25.17 ng/ml). A strong negative correlation of Vitamin D levels with systolic blood pressure (r=-0.428; p<0.001) and diastolic blood pressure (r= 0.375; p<0.001) was found. CONCLUSIONS: This study found a strong relationship between low vitamin D levels and pre-eclamptic manifestation.

Epidermal growth factor receptor rs17337023 polymorphism in hypertensive gestational diabetic women: A pilot study.

BACKGROUND: Women with gestational diabetes mellitus have an increased risk of developing gestational hypertension, which can increase fetal and neonatal morbidity and mortality. In the past decade, single nucleotide polymorphisms in several genes have been identified as risk factors for development of gestational hypertension. The epidermal growth factor receptor activates tyrosine kinase mediated blood vessels contractility; and inflammatory cascades. Abnormalities in these mechanism are known to contribute towards hypertension. It is thus plausible that polymorphisms in the epidermal growth factor receptor gene would be associated with the development of hypertension in women with gestational diabetes. AIM: To determine whether the epidermal growth factor receptor rs17337023 SNP is associated with the occurrence of hypertension in gestational diabetic women. METHODS: This pilot case-control study was conducted at two tertiary care hospitals in Karachi, from January 2017-August 2018. Two hundred and two women at 28 week of gestation with gestational diabetes were recruited and classified into normotensive (n = 80) and hypertensive (n = 122) groups. Their blood samples were genotyped for epidermal growth factor receptor polymorphism rs17337023 using tetra-ARMS polymerase chain reaction. Descriptive analysis was applied on baseline data. Polymorphism data was analyzed for genotype and allele frequency determination using chi-squared statistics. In all cases, a P value of < 0.05 was considered significant. RESULTS: Subjects were age-matched and thus no difference was observed in relation to age of the study subjects (P >0.05). Body fat percentage was significantly higher in hypertensive females as compared to normotensive subjects (35.138 ± 4.29 Case vs 25.01 ± 8.28 Control; P < 0.05). Similarly, systolic and diastolic blood pressures among groups were significantly higher in hypertensive group than the normotensive group (P < 0.05). Overall epidermal growth factor receptor rs17337023 polymorphism genotype frequency was similar in both groups, with the heterozygous AT genotype (56 in Case vs 48 in Control; P = 0. 079) showing predominance in both groups. Furthermore, the odds ratio for A allele was 1.282 (P = 0.219) and for T allele was 0.780 (P = 0.221) in this study. CONCLUSION: This pilot study indicates that polymorphisms in rs17337023 may not be involved in the pathophysiology of gestational hypertension in gestational diabetes via inflammatory cascade mechanism. Further large-scale studies should explore polymorphism in epidermal growth factor receptor and other genes in this regard.

Suppressor of cytokine signaling-3 in pregnant females with or without hypertension.

Suppression of Cytokine Signalling-3 (SOCS-3) modulates the inflammatory pathways responsible for vascular stability. Therefore, we aimed to estimate SOCS-3 levels in 2nd trimester pregnant females and correlate it with blood pressure. A case control study recruiting (n=111) females was conducted at the Aga Khan University. They were classified as pregnancy induced hypertensives ornormotensive as per American College of Obstetricians and Gynecologists Guidelines. Weight, Body mass index, lipid profile and blood glucose were recorded while SOCS-3 was measured by ELISA. Higher SOCS-3 levels were seen in hypertensive group (30 pg/ml) versus normotensive (16 pg/ml). Both Systolic & diastolic blood pressure (r=0.520; p <0.001) (r=0.490; p <0.001) showed an independent significant positive correlation with SOCS-3 level. It is safe to suggest that SOCS-3 has an association of causing high blood pressure. However, more research needs to be conducted to establish a mechanism and chronological order to these events in a pregnant female.

Association of Vaspin levels and its SNP rs2236242 with Gestational Diabetes at a tertiary care setting : RESEARCH ARTICLE.

OBJECTIVE: To evaluate and correlate vaspin levels and genotype frequency in gestational diabetes mellitus. METHODS: The case-control study was conducted at Aga Khan University, Karachi, from November 2015 to December 2016, and comprised pregnant women in their second trimester with gestational diabetes mellitus. Healthy pregnant women with similar characteristics were enrolled as the control group. Tetra arms amplification system for vaspin gene was performed. SPSS 21 was used for data analysis. RESULTS: Of the 112 pregnant women, 67(60%) were normo-glycaemic and 45(40%) had gestational diabetes. Those with gestational diabetes had a higher body mass index (p=0.047) and fasting blood glucose levels (p<0.01). Serum vaspin concentrations were significantly lower in the healthy group compared to the diabetics (p=0.041). Genotype and allele frequencies followed Hardy Weinberg's Equilibrium but no significant differences were observed in genotype distribution between the groups (p>0.05).. CONCLUSIONS: Higher serum vaspin levels were seen in gestational diabetic females, but genotype and allele frequencies showed no association of vaspin with gestational diabetes mellitus.