Elevated Plasma Levels of Galactin-3 in Women with Gestational Diabetes Mellitus, A New Surrogate for Cardiovascular Disease in Women?

Yeela Talmor-Barkan Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel Chava Chezar-Azerrad Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel Dorit Leshem-Lev Department of Cardiology, Felsenstein Medical Center, Petah Tikva, Israel Eran Hadar Department of Gynecology, Rabin Medical Center, Petach Tikva, Israel Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel Ran Kornowski Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel Avital Porter Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Background: Gestational diabetes mellitus (GDM) is recognized as a risk factor for cardiovascular disease (CVD) in women, and is related to future major cardiovascular events. Galactin-3 (Gal-3), a glycoprotein secreted by activated cardiac macrophages, has a role in atherogenesis through several pathways. Increased levels of Gal-3 above 8.7ng/mL has been found to be an independent predictor of increased mortality after cardiac injury. Protein convertase subtilisin/kexin type 9 (PCSK-9), a novel target for low-density lipoprotein (LDL) cholesterol reduction, is associated with metabolic disorders in young women.

Aim: To evaluate plasma levels of Gal-3 and PCSK-9 in pregnant women with GDM, thereby suggesting possible new mechanisms leading to future cardiovascular injury in this population.

Methods: From November 2016 thru July 2017 we collected blood samples from 15 women with normal pregnancies and 29 women diagnosed with GDM in their third trimester. Levels of Hemoglobin A1C (HbA1C), LDL, high-density lipoprotein (HDL), triglycerides, Gal-3 and PCSK-9 levels were measured.

Results: Plasma levels of Gal-3 were increased in pregnancies complicated with GDM compared to normal pregnancies (GDM 9.2±0.4ng/ml vs control 7.4±0.5ng/ml; pv=0.03). Additionally; 62% of women with GDM had Gal-3 concentration > 8.7 ng/mL compared to 13% in the control group.

Plasma levels of PCSK-9 did not differ between the two groups (GDM 550±33ng/ml vs control 553±50ng/ml; pv-ns). No significant differences were observed in HbA1C, LDL, HDL and triglycerides levels.

Conclusion: In the present study, we demonstrated increased levels of Gal-3 without any differences in PCSK-9 levels in women with GDM in their 3rd trimester. In addition, 62% of the women with GDM had elevated plasma levels of Gal-3, a marker of worse prognosis following cardiac injury. These results are hypothesis generating and may suggest a novel mechanism of increased cardiovascular risk among women who had GDM.









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