Summary
Plasma unconjugated estrone (E1), estradiol-17β (E2) and estriol (E3), and HCS were measured in the same plasma samples collected throughout pregnancy in 19 gestational diabetics (GD) and 21 diabetics (D). When compared to the results obtained in 22 normal subjects, plasma levels of E1 and E2 were significantly elevated in D in the second half of gestation. The results were intemediate although closer to the normals, in GD. E3 values were not different from the normals in both D and GD. HCS values were lower than normal in early pregnancy in both D and GD. In late pregnancy HCS levels were not different from normal in either D or GD, although some individual values were much above the upper limit in some diabetic patients. The hormonal ratios in D and GD parallel those in normals, although E3/E2 and HCS/E2 were lower in D. These results are discussed with respect to the different behaviour of E2 and E3, taking into account the difference in their respective biosynthetic pathways. Besides a possible quantitative modification of the placental function in D, the results could tentatively be explained by a qualitative change in the fetal estrogen precursors to placental aromatization, in favour of the 16-non-hydroxylated compound. However, maternal modifications in precursor production or in estrogen metabolism can be an alternative hypothesis. Finally, the present work does not support the hypothetical estrogen deficiency in diabetic pregnancy. Estrogen treatment appears to have no objective justification.
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Lyngbye, J.: Oestrogen metabolism in diabetic pregnancy. Dan med. Bull.17, 173–189 (1970)
Gillmer, M. D. G., Beard, R. W.: Fetal and placental function test in diabetic pregnancy. In: Carbohydrate metabolism in pregnancy and the newborn (eds. H. W. Sutherland, J. M. Stowers), pp. 168–194. Edinburgh: Churchill Livingstone 1975
Selenkow, H. A., Varma, K., Younger, D., White, P., Emerson, K.: Patterns of serum immunoreactive human placental lactogen (IR-HPL) and chorionic gonadotropin (IR-HCG) in diabetic pregnancy. Diabetes20, 696–706 (1971)
Van Leusden, H. A.: Hormonal changes in pathological pregnancy. Vitam. and Horm.30, 281–361 (1970)
Cohen, S. L.: The excretion of labile oestrogens during human pregnancy. Acta endocr. (Kbh.)67, 687–697 (1971)
Easterling, W. E., Talbert, L. M.: Estriol excretion in normal and complicated pregnancies. Amer. J. Obstet. Gynec.107, 417–422 (1970)
Lindberg, B. S., Johansson, E. D. B., Nilsson, B. O.: Plasma levels of non conjugated oestradiol-17β and oestriol in high risk pregnancies. Acta obstet. gynec. scand. Suppl.32, 37–51 (1974)
Masson, G. M., Sutherland, H. W.: Plasma oestriol in pregnancy complicated by diabetes mellitus. J. Obstet. Gynaec. Brit. Cwlth80, 536–541 (1973)
Levitz, M., Selinger, M.: Plasma oestriol levels in class D diabetes of pregnancy. Amer. J. Obstet. Gynec.108, 82–84 (1970)
Svendsen, R., Sorensen, B.: The concentration of unconjugated oestrone and 17β-oestradiol in plasma during pregnancy. Acta endocr. (Kbh.)47, 237–244 (1964)
Nachtigall, L., Bassett, M., Hogsander, U., Levitz, M.: Plasma estriol levels in normal and abnormal pregnancies: An index of fetal welfare. Amer. J. Obstet. Gynec.101, 638–648 (1968)
Cleary, E., Young, P. C. M.: Serum unconjugated estriol in normal and abnormal pregnancy. Amer. J. Obstet. Gynec.118, 18–24 (1974)
Roy, E. J., Kerr, M. G.: The concentration of oestrogens in the peripheral blood of the pregnant diabetic woman. J. Obstet. Gynec.71, 106–111 (1964)
De Hertogh, R., Thomas, K., Hoet, J. J., Ekka, E.: Plasma levels of unconjugated estrogens in normal and diabetic pregnancies. Amer. J. Obstet. Gynec.117, 1076–1079 (1973)
Klopper, A., Sutherland, H. W.: Hormones of the feto-placental unit in diabetes. In: Carbohydrate metabolism in pregnancy and the newborn (eds. H. W. Sutherland, J. M. Stowers), pp. 58–66. Edinburgh: Churchill Livingstone 1975
Spellacy, W. N., Buhi, W. C., Birk, S. A., McCreary, S. A.: Distribution of human placental lactogen in the last half of normal and complicated pregnancies. Amer. J. Obstet. Gynec.120, 214–223 (1974)
Wiese, J., Molsted-Pedersen, L., Lebech, P. E.: Human chorionic somatomammotropin in diabetic pregnancies. Acta endocr. (Kbh.) Suppl.182, 44–51 (1974)
Lindberg, B. S., Nilsson, B. A.: Human placental lactogen (HPL) levels in abnormal pregnancies. J. Obstet. Gynec. Brit. Cwlth.80, 1046–1053 (1973)
Cohen, M., Haour, F., Dumont, M., Bertrand, J.: Prognostic value of human chorionic somatomammotropin plasma levels in diabetic patients. Amer. J. Obstet. Gynec.115, 202–210 (1973)
De Hertogh, R., Thomas, K., Bietlot, Y., Vanderheyden, I., Ferin, J.: Plasma levels of unconjugated estrone, estradiol and estriol and of HCS throughout pregnancy in normal women. J. clin. Endocr.40, 93–101 (1975)
Lubchenco, L. O., Hansman, C., Backstom, L.: Factors influencing fetal growth. In: Aspects of prematurity and dysmaturity (eds. J. H. P. Jonxis, H. K. A. Visser, J. A. Troelstra), pp. 149–166. Leiden: H. E. Stenfert Kroese N. V. 1968
De Hertogh, R.: Radioimmunoassay of estrone and estradiol-17β in peripheral plasma of pregnant and non-pregnant women. J. Ster. Biochem.4, 75–84 (1973)
Thomas, K., Beckers, C., Ferin, J. In: Gonadotropins (eds. B. B. Saxena, G. Beling, L. Gandy), p. 377. New York: Wiley-Interscience 1972
Ajabor, L. N., Yen, S. S. C.: Effect of sustained hyperglycaemia on the levels of human chorionic somatomammotrophin in mid-pregnancy. Amer. J. Obstet. Gynec.112, 908–911 (1972)
Gaspard, U., Sandront, H., Luyckx, A.: Glucose-insulin interaction and the modulation of human placental lactogen (HPL) secretion during pregnancy. J. Obstet. Gynec. Brit. Cwlth.81, 201–209 (1974)
Sybulski, S.: In vitro estrogen biosynthesis from testosterone by homogenates of placentas from normal pregnancies and pregnancies complicated by intrauterine fetal malnutrition and diabetes. Amer. J. Obstet. Gynec.105, 1055–1062 (1969)
Lehmann, W. D., Misinger, J., Lauritzen, C. H.: Umwandlungsrate von 414C Dehydroepiandrosteron in Oestron und Oestradiol-17β durch normale sowie Gestose- und Diabetes -Placemen. Arch. Gynäk.210, 49–60 (1971)
Townsley, J. D., Rubin, E. J., Crystle, C. D.: Evaluation of placental 3-sulfatase and aromatase activities as regulators of estrogen production in human pregnancy. Amer. J. Obstet. Gynec.117, 345–350 (1973)
Lauritzen, C. H.: Dynamic tests of feto-placental function and endocrine therapy. In: Hormonal investigations in human pregnancy (ed. R. Scholler), pp. 399–418. Paris: SEPE 1974
Siiteri, P. K., Mc Donald, P. C.: Placental estrogen biosynthesis during human pregnancy. J. clin. Endocr.26, 751–761 (1966)
Bolte, E., Wiqvist, N., Diczfalusy, E.: Metabolism of dehydroepiandrosterone and dehydroepiandrosterone sulphate by the human foetus at midpregnancy. Acta endocr. (Kbh.)52, 583–597 (1966)
Jungmann, R. A., Schweppe, J. S.: Biosynthesis and metabolism of neutral steroids by human midterm placenta and fetal liver. J. clin. Endocr.27, 1151–1160 (1967)
Chattoraj, S. C., Carroll, C. J., Turner, A. K., Gillespie, L., Pinkus, J. L., Charles, D.: Carbohydrate intolerance. Its influence on maternal and fetal levels of cortisol and cortisone. Obstet, and Gynec.44, 646–656 (1974)
Bech, K.: Morphology of the fetal adrenal cortex, and maternal urinary oestriol excretion in pregnancy. Acta obstet. gynec. scand.50, 215–221 (1971)
Naeye, R. L.: Infants of diabetic mothers: A quantitative morphologic study. Pediatrics35, 980–989 (1965)
Cleary, R. E., Pion, R. J.: Urinary excretion of 16α-hydroxydehydroepioandrosterone and 16-ketoandrostenediol during the early neonatal period. J. clin. Endocr.28, 372–378 (1968)
Booth, M., Elgarf, T. A. R.: Plasma progesterone concentration during the third trimester of diabetic pregnancy. J. Obstet. Gynaec. Brit. Cwlth.81, 768–776 (1974)
Klebe, J. G., Gaede, P.: Serum progesterone in diabetic pregnancy. Acta endocr. (Kbh.) Suppl.182, 25–34 (1974)
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De Hertogh, R., Thomas, K., Hoet, J.J. et al. Plasma concentrations of unconjugated estrone, estradiol-17β and estriol, and HCS throughout pregnancy in diabetics and gestational diabetics. Diabetologia 12, 455–461 (1976). https://doi.org/10.1007/BF01219509
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DOI: https://doi.org/10.1007/BF01219509