Endothelial disorders in pregnant women with obesity and gestational diabetes mellitus

Pregnancy in obese women is often complicated by hypertensive disorders, Gestational Diabetes Mellitus (GDM), diabetic fetopathy. The aim of the study was to investigate endothelial and hormonal parameters in the blood of pregnant women with gestational diabetes mellitus in the setting of obesity and their influence on the occurrence of perinatal complications. The 54 pregnant women included in the study were divided into four groups: obese pregnant women without GDM (n=12), non-obese pregnant women with GDM (n=16), and obese pregnant women with GDM (n=15), who were compared with healthy non-obese pregnant women (n=11). Indicators of endothelial dysfunction, obesity hormones, cytokines, namely Vascular Endothelial Growth Factor (VEGF), EndoThelin-1 (ET-1), eNOS, leptin, adiponectin, IL-1ß, IL-10 were studied. There were changes in endothelial parameters in pregnant women with GDM against the background of obesity and GDM alone, which significantly differed from the group of obese pregnant women and control subjects (р<0.001), indicating the possibility of developing endothelial dysfunction in pregnant women under the influence of GDM. The levels of leptin, adiponectin and IL-10 significantly increased in obese pregnant women with GDM, while IL-1ß significantly differed from the control values only in obese pregnant women. Therefore, these hormones and cytokines may influence the occurrence of GDM in obese women and should be taken into account when planning pregnancy and childbirth. The harmful effects associated with GDM may be exacerbated by maternal supraphysiological weight gain during pregnancy. That is why determination of VEGF, ET-1, eNOS, leptin, adiponectin, IL-1ß and IL-10 levels in obese women with gestational diabetes is extremely important for choosing an adequate algorithm for pregnancy management and for identifying perinatal lesions, and, if necessary, inducing labour to improve maternal and perinatal outcomes. Keywords: pregnancy, VEGF, ET-1, eNOS, leptin, adiponectin.