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Growth Horm IGF Res. 2011 Feb;21(1):25-30. doi: 10.1016/j.ghir.2010.12.001. Epub 2011 Jan 6.

Pregnancy-induced increase in circulating IGF-I is associated with progression of diabetic retinopathy in women with type 1 diabetes.

Author information

  • 1Center for Pregnant Women with Diabetes, Rigshospitalet, Denmark. enel@dadlnet.dk

Abstract

OBJECTIVE:

To evaluate the influence of Insulin-like Growth factor-I (IGF-I) and Placental Growth Hormone (GH) on progression of diabetic retinopathy during pregnancy in women with type 1 diabetes.

DESIGN:

Observational study of 88 consecutive pregnant women with type 1 diabetes for median 16.5 years (range 1-36) and HbA(1c) 6.6% (5.2-10.5) in early pregnancy. At 8, 14, 21, 27 and 33 weeks blood samples were drawn for measurement of IGF-I, placental GH and Hemoglobin A(1c) (HbA(1c)) and blood pressure was recorded. Fundus photography was performed at 8 and 27 weeks. Diabetic retinopathy was classified in five stages. Progression was defined as deterioration of at least one stage of diabetic retinopathy and/or development of macular edema on at least one eye.

RESULTS:

Placental GH and IGF-I levels increased throughout pregnancy and new onset or progression of diabetic retinopathy occurred in 22 (25%). A steeper increase in women with progression of diabetic retinopathy resulted in higher IGF-I levels at 27 weeks (p=0.01) and 16% higher IGF-I levels throughout pregnancy (p=0.02) compared with women without progression while similar levels of placental GH (p=0.58) and HbA(1c) (p=0.85) were observed throughout pregnancy. In a multivariate logistic regression analysis, progression of diabetic retinopathy was associated with higher IGF-I levels at 33 weeks (odds ratio 2.0 [95% confidence interval 1.1-3.6], p=0.02) and higher systolic blood pressure at 8 weeks (1.9 [1.1-3.2], p=0.02) independent of placental GH and HbA(1c) levels.

CONCLUSIONS:

Pregnancy-induced increase in IGF-I levels is associated with progression of diabetic retinopathy in women with type 1 diabetes.

Copyright © 2010 Growth Hormone Research Society. Published by Elsevier Ltd. All rights reserved.

PMID:
21212010
[PubMed - indexed for MEDLINE]
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