The relationship of serum AGE levels in diabetic mothers with adverse fetal outcome.

摘要

OBJECTIVE: To investigate changes in serum-advanced glycosylation end product (AGE) levels in gestation diabetic mothers (GDMs) and its relationship with adverse fetal outcome. STUDY DESIGN: A total of 60 GDMs in mid-gestation and 72 late-gestation GDMs fulfilling the inclusion criteria were recruited. Seventy-two mid-gestation and 80 late-gestation mothers with no pregnancy complications acted as controls. Fasting blood glucose and serum AGE levels were analyzed in each group. Clinical data on these women and their perinatal outcomes were collected. Maternal serum AGE levels and changes in blood glucose between mid-gestation groups and late-gestation groups were compared. Factors, including AGE levels, affecting the prevalence of complications of fetal outcome in GDMs were investigated. RESULT: Mid-gestation and late-gestation GDMs had significantly higher serum AGE levels and fasting blood glucose than their respective controls (P<0.001 and P<0.05, respectively). After treatment mid-gestation GDMs had significantly lower blood glucose levels at late gestation (P<0.05), but their serum AGE levels remained relatively high. There were no significant changes in serum AGE levels from mid- to late gestation. Women with GDM who had abnormal fetal outcomes had significantly higher maternal serum AGE levels than controls with normal fetal outcome (P<0.05). Particularly, those pregnancies that resulted in birth asphyxia, congenital malformations or stillbirth had higher serum AGEs (P<0.05). Logistic regression analysis showed elevated AGEs as a predictor of adverse perinatal outcome in GDMs, OR=6.285 (P<0.001, 95% CI 2.561 to 15.534). CONCLUSION: High-serum AGE is an adverse factor in perinatal outcomes in GDMs. Sustained high AGE levels from mid- to late gestation could be an indicator of adverse perinatal outcomes.