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Haptoglobin phenotype, pre-eclampsia, and response to supplementation with vitamins C and E in pregnant women with type-1 diabetes.

AbstractOBJECTIVE:
The phenotype of the antioxidant and pro-angiogenic protein haptoglobin (Hp) predicts cardiovascular disease risk and treatment response to antioxidant vitamins in individuals with diabetes. Our objective was to determine whether Hp phenotype influences pre-eclampsia risk, or the efficacy of vitamins C and E in preventing pre-eclampsia, in women with type-1 diabetes.
DESIGN:
This is a secondary analysis of a randomised controlled trial in which women with diabetes received daily vitamins C and E, or placebo, from 8 to 22 weeks of gestation until delivery.
SETTING:
Twenty-five antenatal metabolic clinics across the UK (in north-west England, Scotland, and Northern Ireland).
POPULATION:
Pregnant women with type-1 diabetes.
METHODS:
Hp phenotype was determined in white women who completed the study and had plasma samples available (n = 685).
MAIN OUTCOME MEASURE: RESULTS:
Compared with Hp 2-1, Hp 1-1 (OR 0.59, 95% CI 0.30-1.16) and Hp 2-2 (OR 0.93, 95% CI 0.60-1.45) were not associated with significantly decreased pre-eclampsia risk after adjusting for treatment group and HbA1c at randomisation. Our study was not powered to detect an interaction between Hp phenotype and treatment response; however, our preliminary analysis suggests that vitamins C and E did not prevent pre-eclampsia in women of any Hp phenotype (Hp 1-1, OR 0.77, 95% CI 0.22-2.71; Hp 2-1, OR 0.81, 95% CI 0.46-1.43; Hp 2-2, 0.67, 95% CI 0.34-1.33), after adjusting for HbA1c at randomisation.
CONCLUSIONS:
The Hp phenotype did not significantly affect pre-eclampsia risk in women with type-1 diabetes.
AuthorsT L Weissgerber, R E Gandley, J M Roberts, C C Patterson, V A Holmes, I S Young, D R McCance, Diabetes and Pre-eclampsia Intervention Trial (DAPIT) Study Group
JournalBJOG : an international journal of obstetrics and gynaecology (BJOG) Vol. 120 Issue 10 Pg. 1192-9 (Sep 2013) ISSN: 1471-0528 [Electronic] England
PMID23718253 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Copyright© 2013 RCOG.
Chemical References
  • Antioxidants
  • Haptoglobins
  • Vitamin E
  • Ascorbic Acid
Topics
  • Antioxidants (metabolism, therapeutic use)
  • Ascorbic Acid (therapeutic use)
  • Diabetes Mellitus, Type 1 (complications)
  • Female
  • Haptoglobins (chemistry, metabolism)
  • Humans
  • Odds Ratio
  • Oxidative Stress (drug effects)
  • Phenotype
  • Pre-Eclampsia (blood, etiology, prevention & control)
  • Pregnancy
  • Pregnancy in Diabetics (blood)
  • Risk Factors
  • Vitamin E (therapeutic use)

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