Skip to main content
Log in

Diabetes, myometrium, and mitochondria in pregnant women at term

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

Aims

Poor myometrial contractility has been demonstrated in women at term with diabetes and decreased muscular mitochondrial content and/or function has been extensively implicated in the progression of type 2 diabetes. Alterations of the uterine mitochondrial phenotype in pregnant women with diabetes have yet to be investigated as a causal link to decreased myometrial contractility.

Methods

Observational study of 18 women with diabetes (type 2 and gestational) scheduled for an elective Caesarean section at term with matching controls. A uterine biopsy and fasting blood samples were taken on the day of delivery.

Results

Respiration rates in isolated mitochondria and myometrial mRNA levels of genes related to mitochondrial biogenesis were unaffected by diabetes. Mitochondrial quantity examined by quantification of the complexes of the respiratory chain and histology did not indicate alterations in mitochondrial quantity. Citrate syntase activity was higher (0.31 ± 0.02 vs. 0.24 ± 0.02 U/mg protein, P = 0.008), whereas protein content was lower in women with diabetes compared with the control group (94.6 ± 6.9 vs. 118.6 ± 7.4 mg/g wet wt, P = 0.027). Histological examinations did not support any structural alterations in the myometrium or its mitochondria.

Conclusion

No indication of decreased mitochondrial function, content, morphology, or localization in the myometrium at term in women with diabetes compared with controls was observed. The increase in citrate syntase activity in the myometrium could be explained by the lower protein content in the myometrium, which we suggest is due to alterations in tissue or cellular composition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Al-Qahtani S, Heath A, Quenby S et al. (2012) Diabetes is associated with impairment of uterine contractility and high Caesarean section rate. Diabetologia 55(2):489–498. https://doi.org/10.1007/s00125-011-2371-6

    Article  CAS  PubMed  Google Scholar 

  2. Dunne F, Brydon P, Smith K, Gee H (2003) Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990–2002. Diabet Med 20(9):734–738. https://doi.org/10.1046/j.1464-5491.2003.01017

    Article  CAS  PubMed  Google Scholar 

  3. Ehrenberg HM, Durnwald CP, Catalano P, Mercer BM (2004) The influence of obesity and diabetes on the risk of cesarean delivery. Am J Obstet Gynecol 191(3):969–974. https://doi.org/10.1016/j.ajog.2004.06.057

    Article  CAS  PubMed  Google Scholar 

  4. Evers IM, de Valk HW, Visser GH (2004) Risk of complications of pregnancy in women with type 1 diabetes: nationwide prospective study in the Netherlands. BMJ 328(7445):915. https://doi.org/10.1136/bmj.38043.583160.EE

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jensen DM, Damm P, Sorensen B et al. (2003) Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant Danish women. Am J Obstet Gynecol 189(1):239–244. https://doi.org/10.1067/mob.2003.441

    Article  PubMed  Google Scholar 

  6. Ovesen PG, Jensen DM, Damm P, Rasmussen S, Kesmodel US (2015) Maternal and neonatal outcomes in pregnancies complicated by gestational diabetes. a nation-wide study. J Matern Fetal Neonatal Med 28(14):1720–1724. https://doi.org/10.3109/14767058.2014.966677

    Article  PubMed  Google Scholar 

  7. Walsh J, Foley M, O’Herlihy C (2011) Dystocia correlates with body mass index in both spontaneous and induced nulliparous labors. J Matern Fetal Neonatal Med 24(6):817–821. https://doi.org/10.3109/14767058.2010.531313

    Article  PubMed  Google Scholar 

  8. Brown J, Alwan NA, West J et al. (2017) Lifestyle interventions for the treatment of women with gestational diabetes. Cochrane Database Syst Rev 5:CD011970. https://doi.org/10.1002/14651858.CD011970.pub2

    Article  PubMed  Google Scholar 

  9. Jensen DM, Damm P, Moelsted-Pedersen L et al. (2004) Outcomes in type 1 diabetic pregnancies: a nationwide, population-based study. Diabetes Care 27(12):2819–2823. https://doi.org/10.2337/diacare.27.12.2819

    Article  PubMed  Google Scholar 

  10. McMurtrie EM, Ginsberg GG, Frederick GT, Kirkland JL, Stancel GM, Gardner RM (1985) Effect of a diabetic state on myometrial ultrastructure and isolated uterine contractions in the rat. Proc Soc Exp Biol Med 180(3):497–504

    Article  CAS  PubMed  Google Scholar 

  11. Jawerbaum A, Catafau JR, Gonzalez ET et al. (1996) Eicosanoid production, metabolism and contractile activity in the isolated uterus from non-insulin-dependent diabetic rats during late pregnancy. Prostaglandins 51(5):307–320

    Article  CAS  PubMed  Google Scholar 

  12. Jawerbaum A, Rosello Catafau J, Gonzalez ET et al. (1994) Glucose metabolism, triglyceride and glycogen levels, as well as eicosanoid production in isolated uterine strips and in embryos in a rat model of non-insulin-dependent diabetes mellitus during pregnancy. Prostaglandins 47(2):81–96

    Article  CAS  PubMed  Google Scholar 

  13. Jawerbaum A, Gonzalez ET, Catafau JR et al. (1993) Glucose, glycogen and triglyceride metabolism, as well as prostaglandin production in uterine strips and in embryos from diabetic pregnant rats. Influences of the presence of substrate in the incubation medium. Prostaglandins 46(5):417–431

    Article  CAS  PubMed  Google Scholar 

  14. Di Meo S, Iossa S, Venditti P (2017) Skeletal muscle insulin resistance: role of mitochondria and other ROS sources. J Endocrinol 233(1):R15–R42. https://doi.org/10.1530/JOE-16-0598

    Article  Google Scholar 

  15. Goodpaster BH (2013) Mitochondrial deficiency is associated with insulin resistance. Diabetes 62(4):1032–1035. https://doi.org/10.2337/db12-1612

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Holloszy JO (2013) “Deficiency” of mitochondria in muscle does not cause insulin resistance. Diabetes 62(4):1036–1040. https://doi.org/10.2337/db12-1107

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Ritov VB, Menshikova EV, Azuma K et al. (2010) Deficiency of electron transport chain in human skeletal muscle mitochondria in type 2 diabetes mellitus and obesity. Am J Physiol Endocrinol Metab 298(1):E49–58. https://doi.org/10.1152/ajpendo.00317.2009

    Article  CAS  Google Scholar 

  18. Schrauwen-Hinderling VB, Kooi ME, Hesselink MK et al. (2007) Impaired in vivo mitochondrial function but similar intramyocellular lipid content in patients with type 2 diabetes mellitus and BMI-matched control subjects. Diabetologia 50(1):113–120. https://doi.org/10.1007/s00125-006-0475-1

    Article  CAS  PubMed  Google Scholar 

  19. Holloway GP, Thrush AB, Heigenhauser GJ et al. (2007) Skeletal muscle mitochondrial FAT/CD36 content and palmitate oxidation are not decreased in obese women. Am J Physiol Endocrinol Metab 292(6):E1782–1789. https://doi.org/10.1152/ajpendo.00639.2006

    Article  CAS  Google Scholar 

  20. Heilbronn LK, Gan SK, Turner N, Campbell LV, Chisholm DJ (2007) Markers of mitochondrial biogenesis and metabolism are lower in overweight and obese insulin-resistant subjects. J Clin Endocrinol Metab 92(4):1467–1473. https://doi.org/10.1210/jc.2006-2210

    Article  CAS  PubMed  Google Scholar 

  21. Mootha VK, Lindgren CM, Eriksson KF et al. (2003) PGC-1alpha-responsive genes involved in oxidative phosphorylation are coordinately downregulated in human diabetes. Nat Genet 34(3):267–273. https://doi.org/10.1038/ng1180

    Article  CAS  PubMed  Google Scholar 

  22. Patti ME, Butte AJ, Crunkhorn S et al. (2003) Coordinated reduction of genes of oxidative metabolism in humans with insulin resistance and diabetes: potential role of PGC1 and NRF1. Proc Natl Acad Sci USA 100(14):8466–8471. https://doi.org/10.1073/pnas.1032913100

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Hernandez-Alvarez MI, Thabit H, Burns N et al. (2010) Subjects with early-onset type 2 diabetes show defective activation of the skeletal muscle PGC-1{alpha}/Mitofusin-2 regulatory pathway in response to physical activity. Diabetes Care 33(3):645–651. https://doi.org/10.2337/dc09-1305

    Article  CAS  PubMed  Google Scholar 

  24. Mensink M, Hesselink MK, Russell AP, Schaart G, Sels JP, Schrauwen P (2007) Improved skeletal muscle oxidative enzyme activity and restoration of PGC-1 alpha and PPAR beta/delta gene expression upon rosiglitazone treatment in obese patients with type 2 diabetes mellitus. Int J Obes (Lond) 31(8):1302–1310. https://doi.org/10.1038/sj.ijo.0803567

    Article  CAS  Google Scholar 

  25. Hastie R, Lappas M (2014) The effect of pre-existing maternal obesity and diabetes on placental mitochondrial content and electron transport chain activity. Placenta 35(9):673–683. https://doi.org/10.1016/j.placenta.2014.06.368

    Article  CAS  PubMed  Google Scholar 

  26. Qiu C, Hevner K, Abetew D et al. (2013) Mitochondrial DNA copy number and oxidative DNA damage in placental tissues from gestational diabetes and control pregnancies: a pilot study. Clin Lab 59(5–6):655–660

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Gam C, Larsen LH, Mortensen OH et al. (2017) Unchanged mitochondrial phenotype, but accumulation of lipids in the myometrium in obese pregnant women. J Physiol 595(23):7109–7122. https://doi.org/10.1113/JP274838

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Lauenborg J, Grarup N, Damm P et al. (2009) Common type 2 diabetes risk gene variants associate with gestational diabetes. J Clin Endocrinol Metab 94(1):145–150. https://doi.org/10.1210/jc.2008-1336

    Article  CAS  PubMed  Google Scholar 

  29. Wikstrom M, Ahonen P, Luukkainen T (1975) The role of mitochondria in uterine contractions. FEBS Lett 56(1):120–123

    Article  CAS  PubMed  Google Scholar 

  30. Fritzen AJ, Grunnet N, Quistorff B (2007) Flux control analysis of mitochondrial oxidative phosphorylation in rat skeletal muscle: pyruvate and palmitoyl-carnitine as substrates give different control patterns. Eur J Appl Physiol 101(6):679–689 (Epub 2007 Aug 2024)

    Article  CAS  PubMed  Google Scholar 

  31. Grimpo K, Kutschke M, Kastl A, Meyer CW, Heldmaier G, Exner C, Jastroch M (2014) Metabolic depression during warm torpor in the Golden spiny mouse (Acomys russatus) does not affect mitochondrial respiration and hydrogen peroxide release. Comp Biochem Physiol A Mol Integr Physiol 167:7–14. https://doi.org/10.1016/j.cbpa.2013.09.002

    Article  CAS  PubMed  Google Scholar 

  32. Jarmuszkiewicz W, Woyda-Ploszczyca A, Koziel A, Majerczak J, Zoladz JA (2015) Temperature controls oxidative phosphorylation and reactive oxygen species production through uncoupling in rat skeletal muscle mitochondria. Free Radic Biol Med 83:12–20. https://doi.org/10.1016/j.freeradbiomed.2015.02.012

    Article  CAS  PubMed  Google Scholar 

  33. Perry CG, Kane DA, Lanza IR, Neufer PD (2013) Methods for assessing mitochondrial function in diabetes. Diabetes 62(4):1041–1053. https://doi.org/10.2337/db12-1219

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Lowry OH, Rosebrough NJ, Farr AL, Randall RJ (1951) Protein measurement with the Folin phenol reagent. J Biol Chem 193(1):265–275

    CAS  PubMed  Google Scholar 

  35. Kates M (1986) Techniques in Lipidology. Elsevier, New York

    Google Scholar 

  36. Wieland O (1984) Methods of enzymatic analysis, vol VI. Verlag Chemie, Weinheim, pp 504–510

    Google Scholar 

  37. de Melo JF, Aloulou N, Duval JL et al. (2011) Effect of a neonatal low-protein diet on the morphology of myotubes in culture and the expression of key proteins that regulate myogenesis in young and adult rats. Eur J Nutr 50(4):243–250. https://doi.org/10.1007/s00394-010-0132-9

    Article  CAS  PubMed  Google Scholar 

  38. Gam CM, Mortensen OH, Qvortrup K, Damm P, Quistorff B (2015) Effect of high-fat diet on rat myometrium during pregnancy-isolated myometrial mitochondria are not affected. Pflugers Arch 467(7):1539–1549. https://doi.org/10.1007/s00424-014-1599-7

    Article  CAS  PubMed  Google Scholar 

  39. Schrauwen P, Schrauwen-Hinderling V, Hoeks J, Hesselink MK (2010) Mitochondrial dysfunction and lipotoxicity. Biochim Biophys Acta 1801(3):266–271. https://doi.org/10.1016/j.bbalip.2009.09.011

    Article  CAS  PubMed  Google Scholar 

  40. Brand MD, Nicholls DG (2011) Assessing mitochondrial dysfunction in cells. Biochem J 435(2):297–312. https://doi.org/10.1042/BJ20110162

    Article  CAS  PubMed  Google Scholar 

  41. Lekva T, Norwitz ER, Aukrust P, Ueland T (2016) Impact of systemic inflammation on the progression of gestational diabetes mellitus. Curr Diab Rep 16(4):26. https://doi.org/10.1007/s11892-016-0715-9

    Article  CAS  PubMed  Google Scholar 

  42. Evangelista AF, Collares CV, Xavier DJ et al. (2014) Integrative analysis of the transcriptome profiles observed in type 1, type 2 and gestational diabetes mellitus reveals the role of inflammation. BMC Med Genom 7:28. https://doi.org/10.1186/1755-8794-7-28

    Article  CAS  Google Scholar 

  43. Brochner-Mortensen J, Ditzel J (1982) Glomerular filtration rate and extracellular fluid volume in insulin-dependent patients with diabetes mellitus. Kidney Int 21(5):696–698

    Article  CAS  PubMed  Google Scholar 

  44. Fauchald P, Norseth J, Jervell J (1985) Transcapillary colloid osmotic gradient, plasma volume and interstitial fluid volume in long-term type 1 (insulin-dependent) diabetes. Diabetologia 28(5):269–273

    Article  CAS  PubMed  Google Scholar 

  45. Skyler JS, Bakris GL, Bonifacio E et al. (2017) Differentiation of diabetes by pathophysiology, natural history, and prognosis. Diabetes 66(2):241–255. https://doi.org/10.2337/db16-0806

    Article  CAS  PubMed  Google Scholar 

  46. Fernandez-Marcos PJ, Auwerx J (2011) Regulation of PGC-1alpha, a nodal regulator of mitochondrial biogenesis. Am J Clin Nutr 93(4):884S-890. https://doi.org/10.3945/ajcn.110.001917

    Article  CAS  Google Scholar 

  47. Scarpulla RC (2008) Transcriptional paradigms in mammalian mitochondrial biogenesis and function. Physiol Rev 88(2):611–638. https://doi.org/10.1152/physrev.00025.2007

    Article  CAS  PubMed  Google Scholar 

  48. Rasmussen UF, Rasmussen HN (2000) Human skeletal muscle mitochondrial capacity. Acta Physiol Scand 168(4):473–480. https://doi.org/10.1046/j.1365-201x.2000.00699.x

    Article  CAS  PubMed  Google Scholar 

  49. Mogensen M, Sahlin K (2005) Mitochondrial efficiency in rat skeletal muscle: influence of respiration rate, substrate and muscle type. Acta Physiol Scand 185(3):229–236. https://doi.org/10.1111/j.1365-201X.2005.01488.x

    Article  CAS  PubMed  Google Scholar 

  50. Hoppel CL, Tandler B, Fujioka H, Riva A (2009) Dynamic organization of mitochondria in human heart and in myocardial disease. Int J Biochem Cell Biol 41(10):1949–1956. https://doi.org/10.1016/j.biocel.2009.05.004

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We thank Mr. Ib Therkelsen, Panum NMR Center, and Mrs. Bettina Starup Mentz, Section for Cellular and Metabolic Research, for expert technical assistance during the conductance of the experiments. We also thank Ms. Zhila Nikrozi, Core Facility for Integrated Microscopy, and Mrs. Heidi Marie Paulsen, Endocrinology Research Section, for expert technical assistance in section preparation for electron microscopy and light microscopy, respectively. The study is part of Christiane Gam’s Ph.D. project funded by the Faculty of Health and Medical Sciences, University of Copenhagen, and by Ph.D. program of Diabetes and Metabolism, Faculty of Health Sciences, University of Southern Denmark.

Author information

Authors and Affiliations

Authors

Contributions

CG, BQ, PD, OM, and LL planned and designed the study. CG, PD, and EM were responsible for subject inclusion. CG acquired the blood and tissue samples. CG conducted the mitochondrial respiratory experiments. CG, KQ, and SP conducted the histological analyses. CG, OM, and LL conducted the biochemical analyses, including gene and protein expression analyses. CG and OM did the statistical analyses. All authors contributed in writing the manuscript and coordination of the correspondence between authors was organized by CG.

Corresponding author

Correspondence to Christiane Marie Bourgin Folke Gam.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.The study was approved by the regional ethical committee of Copenhagen, Denmark (Protocol No. H-1-2012-070).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Managed by Massimo Federici.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 23 KB)

Supplementary material 2 (DOCX 9538 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gam, C.M.B.F., Mortensen, O.H., Larsen, L.H. et al. Diabetes, myometrium, and mitochondria in pregnant women at term. Acta Diabetol 55, 999–1010 (2018). https://doi.org/10.1007/s00592-018-1171-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-018-1171-6

Keywords

Navigation