Περίληψη:
Objective: Previous studies have underlined the importance of the
carnitine shuttle system and its dysfunction both in normal pregnancy
and in type 1 and 2 diabetes. The objective of this paper was to
delineate more systematically the role of the carnitine shuttle system
in normal pregnancy and in gestational diabetes.
Methods: A total of 119 women matched for age comprised three groups: 40
normal adult non-pregnant women (NNP), 46 normal pregnant women with
uncomplicated pregnancy (NP) and 33 women with gestational diabetes
(GDM). The latter group was further subdivided into those being managed
either by diet alone ( 25 women, GDM-D) or by insulin ( 8 women, GDM-I).
The following biochemical parameters were assayed: fasting plasma total,
free and acyl-carnitine, FFA and beta-OH-butyrate, together with several
essential anthropometric parameters.
Results: Women with GDM, in contrast to the control groups, displayed
the biochemical features characteristic of insulin resistance: higher
body weight, higher BMI, higher skinfold and higher HbA1c levels. No
differences on any parameters were found between the two GDM subgroups.
Both NP and GDM groups had low levels of total carnitine compared to NNP
control group, but surprisingly, the GDM group did not exhibit any
further decrease of carnitine levels, as would have been expected by the
combination of pregnancy and diabetes. Both groups, despite these low
carnitine levels, had no clinical symptoms of carnitine deficiency.
Furthermore, the GDM group displayed higher levels of FFA and
beta-hydroxybutyrate, which were statistically significant compared to
the other two control groups.
Conclusions: The data corroborate the negative effect of normal
gestation on the carnitine shuttle system, while they document for the
first time that GDM does not further affect the efficiency of the
carnitine system. The mild effect of GDM on carnitine status could be
explained by the concurrent increased gluconeogenesis, a process which
does not affect directly carnitine metabolism.
Συγγραφείς:
Pappa, KI
Anagnou, NP
Salamalekis, E
Bikouvarakis, S and
Maropoulos, G
Anogianaki, N
Evangeliou, A
Koumantakis, E
