Maternal Insulin Therapy Increases Fetal Endothelial Progenitor Cells During Diabetic Pregnancy
- Gian Paolo Fadini, MD1,
- Ilenia Baesso, BSC1,
- Carlo Agostini, MD1,
- Emily Cuccato, OBST2,
- Giovanni Battista Nardelli, MD2,
- Annunziata Lapolla, MD3 and
- Angelo Avogaro, MD PHD1
- 1Department of Clinical and Experimental Medicine, University of Padova Medical School, Padova, Italy
- 2Department of Gynecological Science and Human Reproduction, University of Padova Medical School, Padova, Italy
- 3Department of Medical and Surgical Sciences, University of Padova Medical School, Padova, Italy
- Address correspondence and reprint requests to Gian Paolo Fadini, MD, Dipartimento di Medicina Clinica e Sperimentale, Malattie del Metabolismo, Policlinico Universitario v. Giustiniani, 2, 35100 Padova, Italy. E-mail: gianpaolo.fadini{at}unipd.it
Endothelial progenitor cells (EPCs) are bone marrow–derived cells involved in endothelial homeostasis and angiogenesis. Reduction and dysfunction of EPCs have been associated with the development of atherosclerosis and diabetic complications (1,2).
Recent studies in human pregnancies suggest that a mother's EPCs are involved in the physiologic vascular remodeling of systemic and utero-placental circulation (3,4). Hyperglycemia induces dysfunction and apoptosis of EPCs (5); this may impair the development or maturation of the utero-placental circulation, causing maladaptive responses during diabetic pregnancies. Indeed, EPCs have been shown to be dysregulated in pregnant women with diabetes (4).
Little is known about the effects of maternal factors on fetal EPCs. One study showed reduced cord blood EPCs in severe preeclampsia (6), but there were no data on diabetes. This study was undertaken to evaluate quantitative alterations of cord blood progenitor cells during diabetic pregnancies.
RESEARCH DESIGN AND METHODS—
We enrolled 24 nondiabetic and 17 diabetic pregnant women: two had pregravidic type 1 diabetes and 15 had gestational diabetes mellitus (GDM). GDM was diagnosed according to the American Diabetes Association guidelines (7). Provided that informed consent was obtained from the mother, at time of delivery 5 ml of umbilical vein cord blood was collected into heparin tubes for progenitor cell count. The following data about the mother were recorded: age, pregravidic BMI, weight increase, smoking habit, family history of cardiovascular disease, arterial blood pressure, and type of antidiabetic treatment. Before labor, blood samples were collected for determination of plasma glucose levels, leukocyte count, fibrinogen levels, and total cholesterol and triglycerides concentrations. After delivery, gestational age, neonatal …
