Gestational diabetes mellitus is associated with changes in the concentration and bioactivity of placental exosomes in the maternal circulation across gestation.

OBJECTIVE: To compare the placental exosome levels of normal pregnant women and pregnant women with gestational diabetes mellitus (GDM) in different gestational stages, and further investigate the effects of exosomes on the release of cytokines from human umbilical vein endothelial cells. PATIENTS AND METHODS: 20 pregnant women, including 13 normal pregnant women and seven pregnant women with GDM were selected. Blood samples were collected during the three gestational stages (from week 11 to week 14 in the first trimester, from week 22 to week 24 in the second trimester, and from week 32 to week 36 in the third trimester).
RESULTS: Our results showed that both gestational age and physical condition significantly affected the concentration of exosomes in plasma (p < 0.05). The concentration of exosomes in plasma increased with gestational age in both normal pregnant women and pregnant women with GDM, but were increased more significantly in the plasma of pregnant women with GDM (2.2-fold, 1.5-fold, and 1.8-fold higher than in normal pregnant women in the first, second, and third trimester, respectively).
CONCLUSIONS: Exosomes extracted from the plasma of pregnant women with GDM significantly increased the release of inflammatory cytokines from endothelial cells. However, the function of exosomes in pregnant women with GDM has not yet been fully elucidated. The detection of exosomes in plasma could serve as a diagnostic tool for asymptomatic GDM.