Association of low maternal levels of salusins with gestational diabetes mellitus and with small-for-gestational-age fetuses Ebru Celik a, *, Onder Celik a , Ercan Yilmaz a , Ilgin Turkcuoglu a , Abdullah Karaer a , Ugur Turhan a , Suleyman Aydin b a Department of Obstetrics and Gynecology, Inonu University School of Medicine, Malatya, Turkey b Firat University, Medical School, Department of Medical Biochemistry, Elazig, Turkey 1. Introduction Many recent studies have concentrated on the vascular endothelium as a possible target organ in gestational diabetes mellitus (GDM) and disease related to placental insufficiency such as small-for-gestational-age (SGA) [1–4]. A low birth weight appears to be an indicator of fetal adaptations to a suboptimal intrauterine environment. A possible mechanism for fetal adaptive responses, which contribute to SGA, is a negative impact on endothelial function [5]. Endothelial cells have an essential effect on the regulation of vascular tone through the release of vasoactive substances [6]. In pathological pregnancies, such as GDM, SGA or preeclampsia, the synthesis of vasoactive substances is altered, leading to changes in uteroplacental circulation, which could induce slowing of fetal growth and development [7,8]. Salusin-a and salusin-b are recently recognized endogenous bioactive peptides, derived from 28- and 20-amino-acid precursors respectively [9]. Salusins are secreted in various tissues such as blood vessels, kidneys, monocytes and macrophages, as well as being detected in human body fluids [9]. They mainly play a role in the cardiovascular system. An experimental study has indicated that infusion of either salusin-a or salusin-b results in low blood pressure and a marked decrease in heart rate and cardiac output [10]. It has also been reported that salusins may play a key role in promoting mild proliferation in vascular smooth muscle and fibroblast cells, and inhibit cardiomyocyte apoptosis [11]. Salusin- b, however, has more potent effects than salusin-a. The development of vascular endothelial dysfunction may be relevant in women with gestational diabetes who suffer from increased insulin resistance and SGA [12,13]. We therefore evaluated salusin-a and salusin-b levels in such women. The objective of this study was to evaluate maternal and cord serum concentration of salusin-a and salusin-b in women with GDM, SGA and normal healthy pregnancies. 2. Materials and methods Twenty-five pregnant women who were diagnosed with GDM and 20 pregnant women with fetal SGA diagnosed in the outpatient clinic of the Obstetrics and Gynecology Department European Journal of Obstetrics & Gynecology and Reproductive Biology 167 (2013) 29–33 A R T I C L E I N F O Article history: Received 10 August 2012 Received in revised form 3 October 2012 Accepted 29 October 2012 Keywords: Gestational diabetes mellitus Small-for-gestational age Cord blood Salusin-a Salusin-b HOMA-IR A B S T R A C T Objectives: To evaluate maternal and cord serum concentrations of salusin-a and salusin-b in women with gestational diabetes mellitus (GDM) and with small-for-gestational age (SGA) fetuses. Study design: Pregnant women with GDM (n = 25), women with SGA (n = 20) and maternal age-matched normal healthy pregnant subjects (n = 25) participated in the study. Maternal serum and cord blood salusin-a and salusin-b levels at the time of birth were measured using ELISA, and their relation with metabolic parameters was also assessed. Results: Mean concentrations of maternal and fetal serum salusin-a in the GDM and SGA groups were significantly lower than those of the controls (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). Mean concentrations of maternal and cord blood salusin-b also decreased in both the GDM and the SGA groups in comparison to the control group (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). The concentrations of maternal serum salusin-a and salusin-b were strongly positively correlated with the concentrations of cord blood salusin-a and salusin-b (R = 0.92, P < 0.001 and R = 0.94, P < 0.001, respectively). Conclusions: The low levels of maternal serum salusin-a and salusin-b may have negative impact on metabolic disorders and vascular dysfunction. ß 2012 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Department of Obstetrics and Gynecology, Inonu University School of Medicine, Turgut Ozal Medical Center, 44315 Malatya, Turkey. Tel.: +90 422 3410660; fax: +90 422 3410660. E-mail address: ecelik05@googlemail.com (E. Celik). Contents lists available at SciVerse ScienceDirect European Journal of Obstetrics & Gynecology and Reproductive Biology jou r nal h o mep ag e: w ww .elsevier .co m /loc ate/ejo g rb 0301-2115/$ – see front matter ß 2012 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ejogrb.2012.10.032