Abstract
Purpose: :
Inflammation may play an important role in the development of diabetic retinopathy during pregnancy. Glycodelin is a glycoprotein whose secretion from endometrial glands increases during pregnancy. Glycodelin may protect against inflammatory tissue damage. We studied role of glycodelin in the development and progression of retinopathy in type 1 diabetes during pregnancy.
Methods: :
Retinopathy was graded from fundus photographs in 45 diabetic and in 9 nondiabetic women prospectively during pregnancy. Serum glycodelin concentration was measured by an immunofluorometric assay.
Results: :
In diabetic women with progression of retinopathy, glycodelin concentration was 263 [116–505] ng/ml during the first trimester, 61 [30–106] ng/ml during the second trimester, and 29 [13–53] ng/ml during the third trimester, compared with values of 595 [376–870], 104 [75–228] and 45 [32–74], respectively, in diabetics without progression (P = 0.005 between the groups). Low glycodelin concentration was associated with progression of diabetic retinopathy in multiple regression analysis. Serum glycodelin concentration was similar in diabetic and nondiabetic women throughout pregnancy (P = 0.63 by repeated measures ANOVA).
Conclusions: :
Diabetes per se is not associated with altered serum glycodelin concentration during pregnancy. Low glycodelin concentration is associated with progression of retinopathy in pregnant diabetic women. Data suggest that low glycodelin concentration may be insufficient to suppress inflammatory protein levels of cytokines and adhesion molecules known to be associated with retinopathy progression.
Keywords: diabetic retinopathy • retina