Potential prognostic biomarkers of cardiovascular disease in fetal macrosomia: the impact of gestational diabetes

J Matern Fetal Neonatal Med. 2018 Apr;31(7):895-900. doi: 10.1080/14767058.2017.1300651. Epub 2017 Mar 15.

Abstract

Objective: Fetal macrosomia is associated with cardiac hypertrophy and increased cardiovascular risk. Cardiac biomarkers may play diagnostic/prognostic role in cardiovascular disease. We tested whether cardiac biomarkers are differentially expressed in cord blood samples of full-term singleton large-for-gestational-age (LGA), as compared to appropriate-for-gestational-age (AGA) pregnancies.

Methods: Cardiotrophin-1 (CT-1), Titin, pentraxin (PTX-3) and soluble CD36 (sCD36) concentrations were determined in 80 cord blood samples from a) LGA pregnancies due to maternal diabetes (n = 8), overweight/obese (n = 11), excessive weight gain (n = 7), without specific pathology (n = 14), b) AGA normal pregnancies (controls, n = 40). Neonates were classified as LGA or AGA based on customized birth weight (BW) standards.

Results: CT-1 and Titin concentrations were higher in LGA than AGA pregnancies (p < .001 and p = .023, respectively). A subgroup analysis (in the LGA group) showed increased CT-1 concentrations only in diabetic pregnancies. PTX-3 and sCD36 concentrations were similar in LGA and AGA fetuses. In the LGA group, PTX-3 concentrations positively correlated with birth-weight (r = .416, p = .008) and respective sCD36 concentrations (r = .443, p = .004).

Conclusion: Higher Titin concentrations in LGAs possibly represent a candidate molecular mechanism underlying the association between fetal macrosomia and cardiomyocyte/diastolic dysfunction. CT-1 is up-regulated only in LGAs exposed to maternal diabetes. PTX-3 and sCD36 are probably not affected by excessive fetal growth.

Keywords: Cardiotrophin-1; Fetal macrosomia; Titin; cardiovascular biomarkers; pentraxin-3; soluble CD36.

MeSH terms

  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • CD36 Antigens / analysis
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / complications
  • Case-Control Studies
  • Connectin / analysis*
  • Cordocentesis
  • Cytokines / blood*
  • Diabetes, Gestational / blood*
  • Diabetes, Gestational / metabolism
  • Female
  • Fetal Blood / metabolism
  • Fetal Macrosomia / blood*
  • Fetal Macrosomia / complications
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Male
  • Pregnancy
  • Serum Amyloid P-Component / analysis

Substances

  • Biomarkers
  • CD36 Antigens
  • Connectin
  • Cytokines
  • Serum Amyloid P-Component
  • PTX3 protein
  • C-Reactive Protein
  • cardiotrophin 1