Glycodelin: a novel serum anti-inflammatory marker in type 1 diabetic retinopathy during pregnancy.

Purpose: Inflammation may play a role in the development of diabetic retinopathy during pregnancy. Glycodelin is a glycoprotein whose secretion from the endometrial glands increases during pregnancy. Glycodelin has immunosuppressive properties thought to play a role in the protection of the fetoplacental unit. We studied the role of glycodelin in the development and progression of retinopathy in type 1 diabetes during pregnancy.

Methods: Retinopathy was graded from fundus photographs in 45 diabetes subjects and nine non-diabetes subjects prospectively during pregnancy. Serum glycodelin concentration was measured by an immunofluorometric assay.

Results: In women with diabetes with progression of retinopathy, serum glycodelin concentration was 263 ng/ml (range 116-505 ng/ml) during the first trimester, 61 ng/ml (range 30-106 ng/ml) during the second trimester, and 29 ng/ml (range 13-53 ng/ml) during the third trimester, compared with values of 595 ng/ml (range 376-870 ng/ml), 104 ng/ml (range 75-228 ng/ml) and 45 ng/ml (range 32-74 ng/ml), respectively, in diabetes subjects without progression (p = 0.005 between the groups). Low glycodelin concentration was associated with progression of diabetic retinopathy in multiple regression analysis. Serum glycodelin concentration was similar in women with and without diabetes throughout pregnancy (p = 0.63 by repeated measures ANOVA).

Conclusions: Low glycodelin concentration is associated with progression of retinopathy in pregnant women with diabetes. A possible causal relationship between low glycodelin levels and progression of retinopathy may be mediated by the immunomodulatory properties of glycodelin.