Erythrocyte microvesicles and cell-free nucleic acids as biomarkers of gestational diabetes in the third trimester: A comparative study
DOI:
https://doi.org/10.37800/RM.4.2025.607Keywords:
erythrocyte microvesicles , cell-free nucleic acids, biomarkers, gestational diabetes mellitus , pregnancy complicationsAbstract
Relevance: Gestational diabetes mellitus (GDM) affects 7-14% of pregnancies, causing hyperglycemia with maternal (cesarean, preeclampsia) and fetal (macrosomia, hypoglycemia) risks, plus long-term type 2 diabetes and offspring obesity. Pathogenesis involves oxidative stress, inflammation, and apoptosis. Erythrocyte microvesicles (EMVs), cell-free nucleic acids (cfNAs: DNA, RNA, CRF), and advanced oxidation protein products (AOPP) reflect these processes but are underexplored as biomarkers in GDM without preeclampsia/hypertension.
The study aimed to evaluate the diagnostic/prognostic value of EMVs, cfNAs, and AOPP in GDM (no preeclampsia/hypertension) in the third trimester and correlate them with clinical parameters.
Materials and Methods: This cross-sectional study included 24 GDM women (IADPSG criteria, 28-40 weeks) and 24 matched healthy controls from Karaganda Perinatal Centers (2020-2025). Blood was processed for plasma/erythrocytes, and the samples were stored at -80°C. EMVs were quantified by flow cytometry (CD235a); cfNAs by fluorescence; AOPP by spectrophotometry. Statistical analysis included t-tests and Mann-Whitney tests, Pearson correlations, and ROC analysis (p < 0.05).
Results: Groups matched for gestational age (34.2 vs. 33.5 weeks, p = 0.552); GDM older (31.4 vs. 25.2 years, p = 0.010). GDM had higher BP (SBP 145 vs. 110 mmHg; DBP 95 vs. 72 mmHg, p < 0.001) but normal proteinuria. EMVs were elevated (44.3 vs. 15.0 units/mL, p < 0.001). Erythrocyte DNA (0.0203 vs. 0.0109 a.u., p < 0.001), RNA (0.0147 vs. 0.0033 a.u., p = 0.014); CRF lower (0.0057 vs. 0.0250 a.u., p = 0.004). Plasma DNA trended higher (p = 0.092). AOPP increased (0.258 vs. 0.170 a.u., p = 0.001). Correlations: EMV-erythrocyte DNA (r = 0.62), EMV-glucose (r = 0.55), DNA-HOMA-IR (r = 0.46). ROC: EMV AUC 0.90 (sensitivity – 88%, specificity – 83%); erythrocyte DNA AUC 0.87 (sensitivity – 85%, specificity – 80%).
Conclusion: Elevated EMVs, erythrocyte cfNAs, and AOPP in uncomplicated GDM highlight metabolic stress/inflammation, showing strong diagnostic potential. A combination may improve early detection/monitoring.
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Copyright (c) 2025 М.Д. Тойлыбаева , Т.М. Тлеубаева , А.Д. Увашева, Д.Е. Омертаева, М.М. Мугазов, Ж.Т. Амирбекова
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