Fetuin-A expression in human umbilical vein endothelial cells and amnion cells of patients with gestational diabetes mellitus

OBJECTIVES: To elucidate the link between fetuin-A expression in human umbilical vein endothelial cells (HUVECs) and amnion cells (ACs) and clinicopathological changes in patients with gestational diabetes mellitus (GDM) and newborns. METHODS: This retrospective cohort study included 82 pregnant patients (40 with GDM and 42 controls) between January 2019 and January 2022. The patients underwent a one-hour, 50 gram glucose challenge test (GCT) during the 24-28th weeks of pregnancy. Patients with positive GCTs immediately underwent a 3-hour, 100 gram oral glucose tolerance test. The expression level of fetuin-A in UVECs and ACs was evaluated by immunohistochemistry (IHC) and scored based on IHC staining in randomly selected slides. The IHC staining intensity was evaluated by the number of dots, which reflects the expression level of fetuin-A in both HUVECs and ACs. RESULTS: The GDM group displayed significantly higher fetuin-A expression in both HUVECs (p<0.0001) and ACs (p=0.0001) when compared with the control group. Fetuin-A expression in HUVECs was correlated with fetal macrosomia, neonatal hypoglycemia, and placental weight. However, there was no correlation with fetuin-A expression in ACs. CONCLUSION: There is a correlation between fetal macrosomia, neonatal hypoglycemia, placental weight, and fetuin-A expression of HUVECs in patients with GDM.