Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis
Objective: Previous studies have underlined the importance of the carnitine shuttle system and its dysfunction both in normal pregnancy and in type 1 and 2 diabetes. The objective of this paper was to delineate more systematically the role of the carnitine shuttle system in normal pregnancy and in g...
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| Veröffentlicht in: | The journal of maternal-fetal & neonatal medicine 2005-01, Vol.17 (1), p.63-68 |
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| creator | Pappa, Kalliopi I Anagnou, Nicholas P Salamalekis, Emmanuel Bikouvarakis, Stylianos Maropoulos, George Anogianaki, Nektaria Evangeliou, Athanasios Koumantakis, Eugene |
| description | Objective: Previous studies have underlined the importance of the carnitine shuttle system and its dysfunction both in normal pregnancy and in type 1 and 2 diabetes. The objective of this paper was to delineate more systematically the role of the carnitine shuttle system in normal pregnancy and in gestational diabetes.
Methods: A total of 119 women matched for age comprised three groups: 40 normal adult non-pregnant women (NNP), 46 normal pregnant women with uncomplicated pregnancy (NP) and 33 women with gestational diabetes (GDM). The latter group was further subdivided into those being managed either by diet alone (25 women, GDM-D) or by insulin (8 women, GDM-I). The following biochemical parameters were assayed: fasting plasma total, free and acyl-carnitine, FFA and β-OH-butyrate, together with several essential anthropometric parameters.
Results: Women with GDM, in contrast to the control groups, displayed the biochemical features characteristic of insulin resistance: higher body weight, higher BMI, higher skinfold and higher HbA1c levels. No differences on any parameters were found between the two GDM subgroups. Both NP and GDM groups had low levels of total carnitine compared to NNP control group, but surprisingly, the GDM group did not exhibit any further decrease of carnitine levels, as would have been expected by the combination of pregnancy and diabetes. Both groups, despite these low carnitine levels, had no clinical symptoms of carnitine deficiency. Furthermore, the GDM group displayed higher levels of FFA and β-hydroxybutyrate, which were statistically significant compared to the other two control groups.
Conclusions: The data corroborate the negative effect of normal gestation on the carnitine shuttle system, while they document for the first time that GDM does not further affect the efficiency of the carnitine system. The mild effect of GDM on carnitine status could be explained by the concurrent increased gluconeogenesis, a process which does not affect directly carnitine metabolism. |
| doi_str_mv | 10.1080/14767050400028733 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_67702063</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>826120421</sourcerecordid><originalsourceid>FETCH-LOGICAL-c431t-9b4423409b65e0b6f71f31b5a92955ebc39572d776524db984ee926c64b2b2123</originalsourceid><addsrcrecordid>eNp9kTtvVDEQha8QEQmBH0CDLIp0C377WtCgiASkSGmgtmzfuawTr73YXpIt-edx2JXCQ1DNaPSdM5o5w_CC4NcEj_gN4UoqLDDHGNNRMfZoOLqfLbgW_PG-78B4ODyt9apDhGPxZDgkYsRcaXw0_DiH2mwLOdmIpmAdNKgIbpfBhVZRtP4a5Rl5W1JoIQGaYA4-QPLb3tZ1aIAKxO7wHeIWxXzzCxuhDyuyaUI2Nig_91QUErqGlr9Cghrqs-FgtrHC8309Hr6cffh8-nFxcXn-6fT9xcJzRtpCO84p41g7KQA7OSsyM-KE1VQLAc4zLRSdlJKC8snpkQNoKr3kjjpKKDseTna-65K_bfrVZhWqhxhtgrypRiqFKZasg6_-AK_ypvT_VEMxYUxIKjtEdpAvudYCs1mXsLJlawg29-GYv8Lpmpd7441bwfSg2KfRgXc7IKQ5l5W9ySVOptltzGUuNvlQDfuf_9vf5EvoX1_2OODhgn-r7wCEu7Bp</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>201335626</pqid></control><display><type>article</type><title>Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis</title><source>MEDLINE</source><source>Taylor & Francis E-Journals</source><creator>Pappa, Kalliopi I ; Anagnou, Nicholas P ; Salamalekis, Emmanuel ; Bikouvarakis, Stylianos ; Maropoulos, George ; Anogianaki, Nektaria ; Evangeliou, Athanasios ; Koumantakis, Eugene</creator><creatorcontrib>Pappa, Kalliopi I ; Anagnou, Nicholas P ; Salamalekis, Emmanuel ; Bikouvarakis, Stylianos ; Maropoulos, George ; Anogianaki, Nektaria ; Evangeliou, Athanasios ; Koumantakis, Eugene</creatorcontrib><description>Objective: Previous studies have underlined the importance of the carnitine shuttle system and its dysfunction both in normal pregnancy and in type 1 and 2 diabetes. The objective of this paper was to delineate more systematically the role of the carnitine shuttle system in normal pregnancy and in gestational diabetes.
Methods: A total of 119 women matched for age comprised three groups: 40 normal adult non-pregnant women (NNP), 46 normal pregnant women with uncomplicated pregnancy (NP) and 33 women with gestational diabetes (GDM). The latter group was further subdivided into those being managed either by diet alone (25 women, GDM-D) or by insulin (8 women, GDM-I). The following biochemical parameters were assayed: fasting plasma total, free and acyl-carnitine, FFA and β-OH-butyrate, together with several essential anthropometric parameters.
Results: Women with GDM, in contrast to the control groups, displayed the biochemical features characteristic of insulin resistance: higher body weight, higher BMI, higher skinfold and higher HbA1c levels. No differences on any parameters were found between the two GDM subgroups. Both NP and GDM groups had low levels of total carnitine compared to NNP control group, but surprisingly, the GDM group did not exhibit any further decrease of carnitine levels, as would have been expected by the combination of pregnancy and diabetes. Both groups, despite these low carnitine levels, had no clinical symptoms of carnitine deficiency. Furthermore, the GDM group displayed higher levels of FFA and β-hydroxybutyrate, which were statistically significant compared to the other two control groups.
Conclusions: The data corroborate the negative effect of normal gestation on the carnitine shuttle system, while they document for the first time that GDM does not further affect the efficiency of the carnitine system. The mild effect of GDM on carnitine status could be explained by the concurrent increased gluconeogenesis, a process which does not affect directly carnitine metabolism.</description><identifier>ISSN: 1476-7058</identifier><identifier>EISSN: 1476-4954</identifier><identifier>DOI: 10.1080/14767050400028733</identifier><identifier>PMID: 15804790</identifier><identifier>CODEN: JMNMAE</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>3-Hydroxybutyric Acid - blood ; Adult ; Body Mass Index ; Body Weight ; Carnitine - blood ; Carnitine - metabolism ; Case-Control Studies ; Diabetes, Gestational - diet therapy ; Diabetes, Gestational - drug therapy ; Diabetes, Gestational - metabolism ; Diabetes, Gestational - physiopathology ; Fasting - blood ; Fatty Acids, Nonesterified - blood ; Female ; Gestational diabetes mellitus ; Glycated Hemoglobin A - metabolism ; Humans ; Insulin - therapeutic use ; Insulin Resistance ; ketogenesis ; Ketone Bodies - biosynthesis ; l-carnitine shuttle system ; lipid metabolism ; Pregnancy ; Skinfold Thickness</subject><ispartof>The journal of maternal-fetal & neonatal medicine, 2005-01, Vol.17 (1), p.63-68</ispartof><rights>2005 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2005</rights><rights>Copyright CRC Press Jan 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c431t-9b4423409b65e0b6f71f31b5a92955ebc39572d776524db984ee926c64b2b2123</citedby><cites>FETCH-LOGICAL-c431t-9b4423409b65e0b6f71f31b5a92955ebc39572d776524db984ee926c64b2b2123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/14767050400028733$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/14767050400028733$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,59624,60413,61198,61379</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15804790$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pappa, Kalliopi I</creatorcontrib><creatorcontrib>Anagnou, Nicholas P</creatorcontrib><creatorcontrib>Salamalekis, Emmanuel</creatorcontrib><creatorcontrib>Bikouvarakis, Stylianos</creatorcontrib><creatorcontrib>Maropoulos, George</creatorcontrib><creatorcontrib>Anogianaki, Nektaria</creatorcontrib><creatorcontrib>Evangeliou, Athanasios</creatorcontrib><creatorcontrib>Koumantakis, Eugene</creatorcontrib><title>Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis</title><title>The journal of maternal-fetal & neonatal medicine</title><addtitle>J Matern Fetal Neonatal Med</addtitle><description>Objective: Previous studies have underlined the importance of the carnitine shuttle system and its dysfunction both in normal pregnancy and in type 1 and 2 diabetes. The objective of this paper was to delineate more systematically the role of the carnitine shuttle system in normal pregnancy and in gestational diabetes.
Methods: A total of 119 women matched for age comprised three groups: 40 normal adult non-pregnant women (NNP), 46 normal pregnant women with uncomplicated pregnancy (NP) and 33 women with gestational diabetes (GDM). The latter group was further subdivided into those being managed either by diet alone (25 women, GDM-D) or by insulin (8 women, GDM-I). The following biochemical parameters were assayed: fasting plasma total, free and acyl-carnitine, FFA and β-OH-butyrate, together with several essential anthropometric parameters.
Results: Women with GDM, in contrast to the control groups, displayed the biochemical features characteristic of insulin resistance: higher body weight, higher BMI, higher skinfold and higher HbA1c levels. No differences on any parameters were found between the two GDM subgroups. Both NP and GDM groups had low levels of total carnitine compared to NNP control group, but surprisingly, the GDM group did not exhibit any further decrease of carnitine levels, as would have been expected by the combination of pregnancy and diabetes. Both groups, despite these low carnitine levels, had no clinical symptoms of carnitine deficiency. Furthermore, the GDM group displayed higher levels of FFA and β-hydroxybutyrate, which were statistically significant compared to the other two control groups.
Conclusions: The data corroborate the negative effect of normal gestation on the carnitine shuttle system, while they document for the first time that GDM does not further affect the efficiency of the carnitine system. The mild effect of GDM on carnitine status could be explained by the concurrent increased gluconeogenesis, a process which does not affect directly carnitine metabolism.</description><subject>3-Hydroxybutyric Acid - blood</subject><subject>Adult</subject><subject>Body Mass Index</subject><subject>Body Weight</subject><subject>Carnitine - blood</subject><subject>Carnitine - metabolism</subject><subject>Case-Control Studies</subject><subject>Diabetes, Gestational - diet therapy</subject><subject>Diabetes, Gestational - drug therapy</subject><subject>Diabetes, Gestational - metabolism</subject><subject>Diabetes, Gestational - physiopathology</subject><subject>Fasting - blood</subject><subject>Fatty Acids, Nonesterified - blood</subject><subject>Female</subject><subject>Gestational diabetes mellitus</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Insulin - therapeutic use</subject><subject>Insulin Resistance</subject><subject>ketogenesis</subject><subject>Ketone Bodies - biosynthesis</subject><subject>l-carnitine shuttle system</subject><subject>lipid metabolism</subject><subject>Pregnancy</subject><subject>Skinfold Thickness</subject><issn>1476-7058</issn><issn>1476-4954</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kTtvVDEQha8QEQmBH0CDLIp0C377WtCgiASkSGmgtmzfuawTr73YXpIt-edx2JXCQ1DNaPSdM5o5w_CC4NcEj_gN4UoqLDDHGNNRMfZoOLqfLbgW_PG-78B4ODyt9apDhGPxZDgkYsRcaXw0_DiH2mwLOdmIpmAdNKgIbpfBhVZRtP4a5Rl5W1JoIQGaYA4-QPLb3tZ1aIAKxO7wHeIWxXzzCxuhDyuyaUI2Nig_91QUErqGlr9Cghrqs-FgtrHC8309Hr6cffh8-nFxcXn-6fT9xcJzRtpCO84p41g7KQA7OSsyM-KE1VQLAc4zLRSdlJKC8snpkQNoKr3kjjpKKDseTna-65K_bfrVZhWqhxhtgrypRiqFKZasg6_-AK_ypvT_VEMxYUxIKjtEdpAvudYCs1mXsLJlawg29-GYv8Lpmpd7441bwfSg2KfRgXc7IKQ5l5W9ySVOptltzGUuNvlQDfuf_9vf5EvoX1_2OODhgn-r7wCEu7Bp</recordid><startdate>200501</startdate><enddate>200501</enddate><creator>Pappa, Kalliopi I</creator><creator>Anagnou, Nicholas P</creator><creator>Salamalekis, Emmanuel</creator><creator>Bikouvarakis, Stylianos</creator><creator>Maropoulos, George</creator><creator>Anogianaki, Nektaria</creator><creator>Evangeliou, Athanasios</creator><creator>Koumantakis, Eugene</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><general>Taylor & Francis Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>200501</creationdate><title>Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis</title><author>Pappa, Kalliopi I ; Anagnou, Nicholas P ; Salamalekis, Emmanuel ; Bikouvarakis, Stylianos ; Maropoulos, George ; Anogianaki, Nektaria ; Evangeliou, Athanasios ; Koumantakis, Eugene</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c431t-9b4423409b65e0b6f71f31b5a92955ebc39572d776524db984ee926c64b2b2123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>3-Hydroxybutyric Acid - blood</topic><topic>Adult</topic><topic>Body Mass Index</topic><topic>Body Weight</topic><topic>Carnitine - blood</topic><topic>Carnitine - metabolism</topic><topic>Case-Control Studies</topic><topic>Diabetes, Gestational - diet therapy</topic><topic>Diabetes, Gestational - drug therapy</topic><topic>Diabetes, Gestational - metabolism</topic><topic>Diabetes, Gestational - physiopathology</topic><topic>Fasting - blood</topic><topic>Fatty Acids, Nonesterified - blood</topic><topic>Female</topic><topic>Gestational diabetes mellitus</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Insulin - therapeutic use</topic><topic>Insulin Resistance</topic><topic>ketogenesis</topic><topic>Ketone Bodies - biosynthesis</topic><topic>l-carnitine shuttle system</topic><topic>lipid metabolism</topic><topic>Pregnancy</topic><topic>Skinfold Thickness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pappa, Kalliopi I</creatorcontrib><creatorcontrib>Anagnou, Nicholas P</creatorcontrib><creatorcontrib>Salamalekis, Emmanuel</creatorcontrib><creatorcontrib>Bikouvarakis, Stylianos</creatorcontrib><creatorcontrib>Maropoulos, George</creatorcontrib><creatorcontrib>Anogianaki, Nektaria</creatorcontrib><creatorcontrib>Evangeliou, Athanasios</creatorcontrib><creatorcontrib>Koumantakis, Eugene</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of maternal-fetal & neonatal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pappa, Kalliopi I</au><au>Anagnou, Nicholas P</au><au>Salamalekis, Emmanuel</au><au>Bikouvarakis, Stylianos</au><au>Maropoulos, George</au><au>Anogianaki, Nektaria</au><au>Evangeliou, Athanasios</au><au>Koumantakis, Eugene</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis</atitle><jtitle>The journal of maternal-fetal & neonatal medicine</jtitle><addtitle>J Matern Fetal Neonatal Med</addtitle><date>2005-01</date><risdate>2005</risdate><volume>17</volume><issue>1</issue><spage>63</spage><epage>68</epage><pages>63-68</pages><issn>1476-7058</issn><eissn>1476-4954</eissn><coden>JMNMAE</coden><abstract>Objective: Previous studies have underlined the importance of the carnitine shuttle system and its dysfunction both in normal pregnancy and in type 1 and 2 diabetes. The objective of this paper was to delineate more systematically the role of the carnitine shuttle system in normal pregnancy and in gestational diabetes.
Methods: A total of 119 women matched for age comprised three groups: 40 normal adult non-pregnant women (NNP), 46 normal pregnant women with uncomplicated pregnancy (NP) and 33 women with gestational diabetes (GDM). The latter group was further subdivided into those being managed either by diet alone (25 women, GDM-D) or by insulin (8 women, GDM-I). The following biochemical parameters were assayed: fasting plasma total, free and acyl-carnitine, FFA and β-OH-butyrate, together with several essential anthropometric parameters.
Results: Women with GDM, in contrast to the control groups, displayed the biochemical features characteristic of insulin resistance: higher body weight, higher BMI, higher skinfold and higher HbA1c levels. No differences on any parameters were found between the two GDM subgroups. Both NP and GDM groups had low levels of total carnitine compared to NNP control group, but surprisingly, the GDM group did not exhibit any further decrease of carnitine levels, as would have been expected by the combination of pregnancy and diabetes. Both groups, despite these low carnitine levels, had no clinical symptoms of carnitine deficiency. Furthermore, the GDM group displayed higher levels of FFA and β-hydroxybutyrate, which were statistically significant compared to the other two control groups.
Conclusions: The data corroborate the negative effect of normal gestation on the carnitine shuttle system, while they document for the first time that GDM does not further affect the efficiency of the carnitine system. The mild effect of GDM on carnitine status could be explained by the concurrent increased gluconeogenesis, a process which does not affect directly carnitine metabolism.</abstract><cop>England</cop><pub>Informa UK Ltd</pub><pmid>15804790</pmid><doi>10.1080/14767050400028733</doi><tpages>6</tpages></addata></record> |
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| subjects | 3-Hydroxybutyric Acid - blood Adult Body Mass Index Body Weight Carnitine - blood Carnitine - metabolism Case-Control Studies Diabetes, Gestational - diet therapy Diabetes, Gestational - drug therapy Diabetes, Gestational - metabolism Diabetes, Gestational - physiopathology Fasting - blood Fatty Acids, Nonesterified - blood Female Gestational diabetes mellitus Glycated Hemoglobin A - metabolism Humans Insulin - therapeutic use Insulin Resistance ketogenesis Ketone Bodies - biosynthesis l-carnitine shuttle system lipid metabolism Pregnancy Skinfold Thickness |
| title | Gestational diabetes exhibits lack of carnitine deficiency despite relatively low carnitine levels and alterations in ketogenesis |
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