Gene Expression Profile in Whole Blood Cells of Mild Gestational Hyperglycemic Women

Abstract

The use of two tests applied in parallel [(GTT100g and glycemic profile (GP)] identified four groups of pregnant women: IA - non-diabetic pregnant women with both tests normal; IB - carrier from gestational hyperglycemia with only the altered GP; IIA - carrier of GDM with only altered GTT75g and IIB - carrier of GDM and / or type 2 Diabetes mellitus (DM2) with two abnormal tests. The new group identified with mild gestational hyperglycemia (MGH) has glucose intolerance, obesity, higher systolic and diastolic blood pressure levels, insulin resistance, which persists six weeks after delivery, compared with IA group. These pregnant women present an increased susceptibility to develop DM2 from 2 to 12 years after the index pregnancy. Despite all our research is still necessary to determine if these pregnant women represent a different group of GDM or just represent the earliest stages of the same pathology. This question has been with us over the past 25 years, because these women have some clinical, laboratory, and placental risk of developing DM2 in an intermediate level between the normal pregnant women and women with GDM. Thus, further identification of pregnant women with MGH will allow an advancement of knowledge regarding the possible "window of opportunity" that pregnancy is giving these women. If this is confirmed with this gene expression evaluation we can advance in the prevention of DM2 and the new syndrome called "diabesity". The present study aims to evaluate the gene expression profile in Mild Gestational Hyperglycemia group (MGH) to identify genetic markers that are related to insulin resistance and changes in glucose homeostasis causing, consequently, changes in the mother that impact on fetal and placental development. The women treated at the Clinical Hospital of Botucatu Medical School will be evaluated and selected based on the absence of chronic and infectious diseases and non-smokers. Patients submitted to both the screening and diagnostic tests will be classified in four groups of pregnant women with positive screening tests for diabetes. Peripheral blood samples of different groups will be collected and these samples will be processed immediately for subsequent RNA extraction, large-scale gene expression and analysis / interpretation of expression data. The genes with altered expression will be subjected to analysis of networks, genetic pathways, diseases and molecular or cellular function using the software Ingenuity Pathways Analysis (IPA) Ingenuity Systems.