Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>To evaluate the inflammatory axis mediated by tumour necrosis factor‐like weak inducer of apoptosis (<jats:styled-content style="fixed-case">TWEAK</jats:styled-content>) and its scavenger receptor <jats:styled-content style="fixed-case">CD</jats:styled-content>163 during pregnancy and their influence on insulin sensitivity in normal pregnancy and in gestational diabetes mellitus (<jats:styled-content style="fixed-case">GDM</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Materials and methods</jats:title><jats:p>One hundred and thirty seven women with one singleton pregnancy, 71 with normal glucose tolerance (NGT) and 66 with <jats:styled-content style="fixed-case">GDM</jats:styled-content> were studied. Glucose metabolism was assessed by oral glucose tolerance test. Serum concentrations of soluble <jats:styled-content style="fixed-case">TWEAK</jats:styled-content> (<jats:styled-content style="fixed-case">sTWEAK</jats:styled-content>) and CD163 (<jats:styled-content style="fixed-case">sCD</jats:styled-content>163) and insulin resistance (<jats:styled-content style="fixed-case">HOMA</jats:styled-content>‐<jats:styled-content style="fixed-case">IR</jats:styled-content> index) were determined in maternal blood drawn at recruitment, in the early third trimester. Offspring weight and height were assessed at birth.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Women with GDM had lower circulating <jats:styled-content style="fixed-case">sTWEAK</jats:styled-content> concentrations than control NGT group (237·8 (192·1–301·0) pg/mL vs. 277·2 (206·4–355·7) pg/mL; <jats:italic>P </jats:italic>=<jats:italic> </jats:italic>0·013). <jats:styled-content style="fixed-case">sTWEAK</jats:styled-content> was negatively associated with the presence of GDM (<jats:italic>r </jats:italic>=<jats:italic> </jats:italic>−0·212; <jats:italic>P </jats:italic>=<jats:italic> </jats:italic>0·013), HOMA‐IR index (<jats:italic>r </jats:italic>=<jats:italic> </jats:italic>−0·197; <jats:italic>P </jats:italic>=<jats:italic> </jats:italic>0·021) and ponderal index of the newborn (<jats:italic>r </jats:italic>=<jats:italic> </jats:italic>−0·196; <jats:italic>P </jats:italic>=<jats:italic> </jats:italic>0·025), but positively with HDL cholesterol (<jats:italic>r </jats:italic>=<jats:italic> </jats:italic>0·283; <jats:italic>P </jats:italic>=<jats:italic> </jats:italic>0·001). In multiple regression analysis, <jats:styled-content style="fixed-case">sTWEAK</jats:styled-content> concentration emerged as one of the main predictors of insulin resistance, along with BMI, triglycerides and low concentrations of HDL cholesterol (R<jats:sup>2</jats:sup> = 0·486; <jats:italic>P </jats:italic><<jats:italic> </jats:italic>0·001). No relationship was found between HOMA‐IR index and <jats:styled-content style="fixed-case">sCD</jats:styled-content>163 or <jats:styled-content style="fixed-case">sCD</jats:styled-content>163/<jats:styled-content style="fixed-case">sTWEAK</jats:styled-content> ratio.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p><jats:styled-content style="fixed-case">sTWEAK</jats:styled-content> concentrations are lower in patients with GDM compared with healthy pregnant women, and low concentrations of <jats:styled-content style="fixed-case">sTWEAK</jats:styled-content> are associated with insulin resistance. These findings suggest that insulin resistance during pregnancy is closely linked to inflammatory imbalance and <jats:styled-content style="fixed-case">sTWEAK</jats:styled-content> may represent a new candidate associated with GDM.</jats:p></jats:sec>