Haptoglobin phenotype, pre-eclampsia, and response to supplementation with vitamins C and E in pregnant women with type-1 diabetes

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Abstract

Objective

The phenotype of the antioxidant and pro-angiogenic protein haptoglobin (Hp) predicts cardiovascular disease risk and treatment response to antioxidant vitamins in individuals with diabetes. Our objective was to determine whether Hp phenotype influences pre-eclampsia risk, or the efficacy of vitamins C and E in preventing pre-eclampsia, in women with type-1 diabetes.

Design

This is a secondary analysis of a randomised controlled trial in which women with diabetes received daily vitamins C and E, or placebo, from 8 to 22 weeks of gestation until delivery.

Setting

Twenty-five antenatal metabolic clinics across the UK (in north-west England, Scotland, and Northern Ireland).

Population

Pregnant women with type-1 diabetes.

Methods

Hp phenotype was determined in white women who completed the study and had plasma samples available (n = 685).

Main outcome measure

Pre-eclampsia.

Results

Compared with Hp 2-1, Hp 1-1 (OR 0.59, 95% CI 0.30–1.16) and Hp 2-2 (OR 0.93, 95% CI 0.60–1.45) were not associated with significantly decreased pre-eclampsia risk after adjusting for treatment group and HbA1c at randomisation. Our study was not powered to detect an interaction between Hp phenotype and treatment response; however, our preliminary analysis suggests that vitamins C and E did not prevent pre-eclampsia in women of any Hp phenotype (Hp 1-1, OR 0.77, 95% CI 0.22–2.71; Hp 2-1, OR 0.81, 95% CI 0.46–1.43; Hp 2-2, 0.67, 95% CI 0.34–1.33), after adjusting for HbA1c at randomisation.

Conclusions

The Hp phenotype did not significantly affect pre-eclampsia risk in women with type-1 diabetes.

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