| 研究課題/領域番号 |
25305034
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| 研究機関 | 筑波大学 |
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研究代表者 |
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| 研究分担者 |
水谷 太郎 筑波大学, 医学医療系, 教授 (80181890)
岩嶋 義雄 独立行政法人国立循環器病研究センター, その他部局等, その他 (80448068)
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| 研究期間 (年度) |
2013-04-01 – 2016-03-31
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| キーワード | 妊娠中糖尿病 / バングラデシュ / 疫学 / 遺伝学 |
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| 研究実績の概要 |
We have completed two years of this research project. In 1st and 2nd years of this project, we estimated the prevalence, the associated risk factors of diabetes in pregnant (gestational diabetes mellitus, GDM) women in Bangladesh and also investigated the important biomarkers of GDM pathogenesis for Bangladesh rural context. Prevalence of GDM was 9.7% according to the WHO criteria and 12.9 % according to the new ADA criteria in this study population. The prevalence of GDM increased significantly with increased age and parity. Prevalence of GDM was higher among women with higher monthly household income. Prevalence was also higher among pregnant women who had hypertension, and had parental history of hypertension and diabetes. Percentage of metabolic syndrome is much higher in GDM pregnant women compared to that in pregnant women without GDM. In addition, BMI is not an important factor for GDM pathogenesis in Bangladesh. Average fasting blood glucose level is twofold higher in GDM positive cases than in non-GDM pregnant women. Vascular endothelial growth factor (VEGF) which is now a potential therapeutic and diagnostic target for various diabetic complications is significantly higher in GDM positive cases compared to GDM negative cases. In general plasma VEGF is upregulated in diabetes subjects compared to non-diabetic subjects. From our analysis, we could not find any significant alterations in angiopoietin system in pregnant women with or without GDM. VEGF has potential alteration in GDM pathogenesis in Bangladeshi women whereas angiopoietin systems are not.
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| 現在までの達成度 (区分) |
現在までの達成度 (区分)
1: 当初の計画以上に進展している
理由
The current research is on right track both from the contexts of time line and the amount of research activities scheduled to be done (100% done with target milestone achievement). As mentioned in our original research application, in first year of this project, we already we performed a cross sectional study undertaken in pregnant women in Bangladesh to determine the prevalence of gestational diabetes mellitus (GDM) in Bangladesh. We could include the planned number of pregnant women in this cross sectional study and we could ensure the quality control of blood sugar estimation in rural aspect in Bangladesh. We already published those findings to two international scientific journals (Jesmin et al, Diabetes Research and Clinical Practice, 2014; Jesmin et al, Journal of Shaheed Ziaur Rahman Medical College, 2014). Through the in depth analysis of that cross sectional study, we also explored the possible risk factors for GDM in Bangladesh (Jesmin et al, submitted, 2015). We already presented GDM project findings in more than ten international meeting with four invited talks to date. In the second year of this project, we started a cohort study including pregnant women as planned during the start of this project and now the regular follow up is done for that cohort study. We could recruit the estimated number of pregnant women to that cohort. The case control study on GDM is also on progress. The measurements of biochemical parameters and the advanced biomarkers are going on smoothly. The genetic analysis of this project has also already begun and is now on progress.
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| 今後の研究の推進方策 |
We are now running a cohort study on pregnant women in Bangladesh. In the third year of this project, we will still continue the ongoing cohort study. We included the pregnant women who were free of diabetes either at the early phase of first trimester or suspecting to be pregnant with pregnancy confirmation and are now longitudinally followed up monthly through sociodemographic data (questionnaire and interview), physical assessment with pregnancy profile, biochemical measurement, till delivery of babies and subsequent followed up for one year. In addition, in 2015 the rest of the part of a case control study will be conducted already started in 2014 using the pregnant women with GDM as cases and pregnant women without GDM as control in rural Bangladesh.
In 2015 we will estimate the followings:
Estimation of incidence rate of GDM; Estimation of clinical outcomes for both mother and child from cohort design; Biochemical measurement: Blood glucose, insulin, lipid profile;Assessment of biomarkers: Inflammatory markers TNF-alpha and hsCRP, pro-atherogenic marker PAI-1, adiponectin, splice variants of VEGF (121,165,188), its downstream signaling cascades (Flk-1, Flt-1, eNOS, Akt, NO) by ELISA;Assessment of fetal fatality;Blood collection for genetic screening
Intensive analysis with specialist statistician of present project data
Data interpretation, publication; Comparison of data on GDM of Bangladeshi women with Japanese women;Presentation of research findings at various national and international meeting;Making a review report on GDM situation in South Asian countries.
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| 次年度使用額が生じた理由 |
Last two years we did not measure the expensive biomarkers from this grant money, we had some donations from local Bangladesh to buy some expensive re-agents.
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| 次年度使用額の使用計画 |
This year we will use the saved money from last two years to measure more expensive biomarkers and also for genetic study.
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