Eryptosis contributes to gestational diabetes mellitus in maternal obesity

Background. Obesity is considered to be a risk factor for Gestational Diabetes Mellitus (GDM), which is characterised by hyperglycaemia in pregnant women. Recent studies have demonstrated that glycated erythrocytes are more prone to eryptosis, a unique regulated cell death observed only in mature erythrocytes. The aim of the current study was to analyse how eryptosis might contribute to GSM in maternal obesity. Materials & Methods. Eryptosis parameters were assessed in pregnant women enrolled for the study: group 1 consisted of 12 obese pregnant women without the signs of GDM, 15 pregnant women without obesity but with GDM were included in group 2, 14 obese pregnant women with GDM were in group 3, group 4 (control) consisted of 15 pregnant women without the signs of obstetric and extragenital pathology. Phosphatidylserine externalisation was assessed by flow cytometry following Annexin V-FITC staining of circulating erythrocytes isolated from the pregnant women. Additionally, 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) staining was used to analyse oxidative stress parameters in circulating erythrocytes. Results. Groups 1, 2 and 3 of pregnant women showed a higher degree of ROS-dependent eryptosis compared to the control group (IV). There was no statistically significant difference (p>0.05) in the eryptosis of circulating erythrocytes between pregnant women of groups 1 and 2. However, the percentage of phosphatidylserine-dispersed erythrocytes in eryptosis and the level of ROS was statistically significantly higher in pregnant women of group 3 compared to pregnant women of groups 1 and 2. Conclusions. GSM associated with maternal obesity is accompanied by accelerated ROS-dependent eryptosis. Enhanced eryptosis might act as an additional factor contributing to thrombosis and endothelial dysfunction in obese pregnant women with GDM. Keywords: pregnancy, phosphatidylserine, flow cytometry, Annexin, erythrocytes.