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Impact of inflammatory factors, hemoglobin A1c, and platelet parameters in gestational diabetes mellitus. Arch Gynecol Obstet 2023; 307:439-446. [PMID: 35362789 DOI: 10.1007/s00404-022-06528-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/14/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE The aim of this study was to evaluate the relationship among inflammatory cytokines including hypersensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6), glycated hemoglobin A1c (HbA1c), and platelet distribution width (PDW) in women with gestational diabetes mellitus (GDM). METHODS Data on 191 pregnant women (96 women with GDM; 95 healthy controls) were extracted from routine prenatal examination records in Nanjing, China. Fasting concentrations of hs-CRP, IL-6, HbA1c, blood cell indices, and glucose at 24-28th gestational weeks were determined. RESULTS The levels of hs-CRP, IL-6, FPG, PG1h, PG2h, HbA1c, RBC, and PDW significantly were increased (P < 0.05) in GDM group. hs-CRP had a positive correlation with HbA1c and PLT (P < 0.05). The odds ratios of HbA1c and PDW were 7.817 (95% CI 1.921-31.816, P = 0.004) and 1.523 (95% CI 1.158-2.002, P = 0.003), respectively. Furthermore, AUC of the combined diagnosis of GDM including HbA1c, FPG, and PDW reached 0.754, with specificity of 80.0% and sensitivity of 60.4%. CONCLUSION Our findings support that elevated levels of hs-CRP, IL-6, HbA1c, and PDW at 24-28th gestational weeks even within the conventional normal range, may be implicated in the pathogenesis of GDM and their evaluation should be part of prenatal care routine.
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Zieleniak A, Zurawska-Klis M, Cypryk K, Wozniak L, Wojcik M. Transcriptomic Dysregulation of Inflammation-Related Genes in Leukocytes of Patients with Gestational Diabetes Mellitus (GDM) during and after Pregnancy: Identifying Potential Biomarkers Relevant to Glycemic Abnormality. Int J Mol Sci 2022; 23:ijms232314677. [PMID: 36499008 PMCID: PMC9737950 DOI: 10.3390/ijms232314677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 11/26/2022] Open
Abstract
Although the immune system has been implicated in the pathophysiology of gestational diabetes mellitus (GDM) and postpartum abnormal glucose tolerance (AGT), little is known about the transcriptional response of inflammation-related genes linked to metabolic phenotypes of GDM women during and after pregnancy, which may be potential diagnostic classifiers for GDM and biomarkers for predicting AGT. To address these questions, gene expression of IL6, IL8, IL10, IL13, IL18, TNFA, and the nuclear factor κB (NFκB)/RELA transcription factor were quantified in leukocytes of 28 diabetic women at GDM diagnosis (GDM group) and 1-year postpartum (pGDM group: 10 women with AGT and 18 normoglycemic women), using a nested RT-PCR method. Control pregnancies with normal glucose tolerance (NGT group; n = 31) were closely matched for maternal age, gestational age, pre-pregnancy BMI, pregnancy weight, and gestational weight gain. Compared with the NGT group, IL8 was downregulated in the GDM group, and IL13 and RELA were upregulated in the pGDM group, whereas IL6, IL10, and IL18 were upregulated in the GDM and pGDM groups. The TNFA level did not change from pregnancy to postpartum. Associations of some cytokines with glycemic measures were detected in pregnancy (IL6 and RELA) and postpartum (IL10) (p < 0.05). Receiver operating characteristic (ROC) curves showed that IL6, IL8, and IL18, if employed alone, can discriminate GDM patients from NGT individuals at GDM diagnosis, with the area under the ROC curves (AUCs) of 0.844, (95% CI 0.736−0.953), 0.771 (95% CI 0.651−0.890), and 0.714 (95% CI 0.582−0.846), respectively. By the logistic regression method, we also identified a three-gene panel (IL8, IL13, and TNFA) for postpartum AGT prediction. This study demonstrates a different transcriptional response of the studied genes in clinically well-characterized women with GDM at GDM diagnosis and 1-year postpartum, and provides novel transcriptomic biomarkers for future efforts aimed at diagnosing GDM and identifying the high risk of postpartum AGT groups.
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Affiliation(s)
- Andrzej Zieleniak
- Department of Structural Biology, Faculty of Biomedical Sciences, Medical University of Lodz, 90-752 Lodz, Poland
| | - Monika Zurawska-Klis
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 92-213 Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 92-213 Lodz, Poland
| | - Lucyna Wozniak
- Department of Structural Biology, Faculty of Biomedical Sciences, Medical University of Lodz, 90-752 Lodz, Poland
| | - Marzena Wojcik
- Department of Structural Biology, Faculty of Biomedical Sciences, Medical University of Lodz, 90-752 Lodz, Poland
- Correspondence: ; Tel.: +48-426-393-238
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Vilotić A, Nacka-Aleksić M, Pirković A, Bojić-Trbojević Ž, Dekanski D, Jovanović Krivokuća M. IL-6 and IL-8: An Overview of Their Roles in Healthy and Pathological Pregnancies. Int J Mol Sci 2022; 23:ijms232314574. [PMID: 36498901 PMCID: PMC9738067 DOI: 10.3390/ijms232314574] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
Interleukin-6 (IL-6) is an acknowledged inflammatory cytokine with a pleiotropic action, mediating innate and adaptive immunity and multiple physiological processes, including protective and regenerative ones. IL-8 is a pro-inflammatory CXC chemokine with a primary function in attracting and activating neutrophils, but also implicated in a variety of other cellular processes. These two ILs are abundantly expressed at the feto-maternal interface over the course of a pregnancy and have been shown to participate in numerous pregnancy-related events. In this review, we summarize the literature data regarding their role in healthy and pathological pregnancies. The general information related to IL-6 and IL-8 functions is followed by an overview of their overall expression in cycling endometrium and at the feto-maternal interface. Further, we provide an overview of their involvement in pregnancy establishment and parturition. Finally, the implication of IL-6 and IL-8 in pregnancy-associated pathological conditions, such as pregnancy loss, preeclampsia, gestational diabetes mellitus and infection/inflammation is discussed.
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Role of interleukin-6 (IL-6) in predicting gestational diabetes mellitus. Obstet Gynecol Sci 2020; 63:407-416. [PMID: 32689769 PMCID: PMC7393755 DOI: 10.5468/ogs.20020] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/01/2020] [Indexed: 12/14/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is the most common pregnancy-associated metabolic disorder that is steadily increasing worldwide. Early diagnosis of pregnant women susceptible to GDM is the first step for deploying effective preventive treatment to reduce maternal, fetal, and neonatal complications. The diagnostic process of GDM is still controversial and interleukin-6 (IL-6) is one of the most recent markers used for the diagnosis of GDM. In this study, we aimed to systematically review the role of IL-6 in the diagnosis of GDM. In this systematic review, Google Scholar, Scopus, PubMed, ISI Web of Science, ProQuest, and MEDLINE databases were searched using the following keywords: GDM, screening, and IL-6, with the time interval 2009–2020. The quality of articles was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Twenty-four articles with desired quality that met the inclusion criteria were selected and reviewed further. Sixteen studies showed a statistically significant association, while 8 studies did not report any relationship between IL-6 levels and GDM. Based on the results of these studies, assessing the serum IL-6 levels can be investigated a newly established diagnostic biomarker for GDM. Therefore, through early diagnosis of susceptible women, effective measures can be implemented to reduce its complications.
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Amirian A, Rahnemaei FA, Abdi F. Role of C-reactive Protein(CRP) or high-sensitivity CRP in predicting gestational diabetes Mellitus:Systematic review. Diabetes Metab Syndr 2020; 14:229-236. [PMID: 32247209 DOI: 10.1016/j.dsx.2020.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Gestational Diabetes Mellitus (GDM) is the most common disorder during pregnancy in 8-18% of pregnancies. Due to maternal and neonatal morbidity and mortality, early diagnosis and appropriate treatment have always been of interest to researchers. One of the recent cases for early diagnosis of GDM is the size of the C-reactive protein (CRP). The purpose of this review study was to investigate the role of CRP or its high sensitivity type in predicting GDM. METHODS Systematic searching of MEDLINE, ISI Web of Science, PubMed, Scopus, Google Scholar, and ProQuest databases between 2009 and 2019 using keywords 'Gestational Diabetes Mellitus','Screening', 'C-reactive protein',' High sensitivity CRP'was performed. The quality of articles was also assessed using the STROBE checklist. RESULTS After a thorough search of the mentioned databases, 31 articles with the desired quality were finally selected. Most of studies showed significant relationship between CRP or high-sensitivity CRP(hs-CRP) level with GDMbutthe relationship was not significant in fewstudies. CONCLUSIONS Blood levels of CRP or hs-CRP could be used as a potential indicator for GDM, but more studies are needed.
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Affiliation(s)
- Azam Amirian
- Department of Midwifery, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Fatemeh Alsadat Rahnemaei
- Student Research Committee, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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Li F, Pei L, Huang G, Ye H. Influence of omega-3 fatty acid and vitamin co-supplementation on metabolic status in gestational diabetes: A meta-analysis of randomized controlled studies. Eur J Obstet Gynecol Reprod Biol 2020; 247:191-197. [PMID: 32145487 DOI: 10.1016/j.ejogrb.2020.02.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Omega-3 fatty acid and vitamin E or D co-supplementation may be an important approach to improve metabolic status in gestational diabetes, but the results are conflicting. This systematic review and meta-analysis was conducted to evaluate the effect of omega-3 fatty acid and vitamin co-supplementation on metabolic status in gestational diabetes. METHODS PubMed, Embase and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials (RCTs) assessing the influence of omega-3 fatty acid and vitamin co-supplementation compared with placebo on metabolic status in gestational diabetes were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. RESULTS Four RCTs were included in the meta-analysis. Compared with control interventions for gestational diabetes, omega-3 fatty acid and vitamin E or D co-supplementation was associated with significantly reduced fasting plasma glucose [mean difference (MD) -10.47, 95 % confidence interval (CI) -15.33 to -5.61, p < 0.0001], homeostasis model of assessment-insulin resistance (MD -1.6, 95 % CI=-2.44 to -0.77, p = 0.0002), malondialdehyde (MD -1.00, 95 % CI -1.05 to -0.95, p < 0.00001) and triglycerides (MD 26.22, 95 % CI -38.94 to -13.51, p < 0.0001), as well as increased antioxidant capacity (MD 173.51, 95 % CI 164.72-182.30, p < 0.00001), but showed no obvious effect on nitric oxide (MD 5.95, 95 % CI -7.48 to 19.37, p = 0.39) or total cholesterol (MD 1.63, 95 % CI -13.46 to 16.72, p = 0.83). CONCLUSIONS Omega-3 fatty acid and vitamin co-supplementation may have a favourable effect on metabolic status in gestational diabetes.
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Affiliation(s)
- Fujie Li
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Li Pei
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Guoning Huang
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Hong Ye
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China.
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Li X, Zhao J. The influence of zinc supplementation on metabolic status in gestational diabetes: a meta-analysis of randomized controlled studies. J Matern Fetal Neonatal Med 2019; 34:2140-2145. [PMID: 31438733 DOI: 10.1080/14767058.2019.1659769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Zinc supplementation has emerged as an important approach to improve metabolic status in gestational diabetes. However, its use has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of zinc supplementation to improve metabolic status for gestational diabetes. METHODS PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials (RCTs) assessing the influence of zinc supplementation (or its combination) versus placebo on metabolic status of gestational diabetes are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model. RESULTS Five RCTs involving 263 patients are included in the meta-analysis. Compared with control intervention for gestational diabetes, zinc supplementation is associated with significantly reduced FPG (std. MD = -0.52; 95% CI = -0.82 to -0.21; p = .0008), insulin (std. MD = -0.68; 95% CI = -0.98 to -0.37; p < .0001), HOMA-IR (std. MD = -0.77; 95% CI = -1.08 to -0.45; p < .00001), and increased QUICKI (std. MD = 0.58; 95% CI = 0.28-0.89; p = .0002) as well as zinc change (std. MD = 0.90; 95% CI = 0.58-1.21; p < .00001), but has no remarkable influence on LDL-cholesterol (std. MD = -0.13; 95% CI = -0.43-0.17; p = .40), and total cholesterol (std. MD = -0.28; 95% CI = -0.63-0.07; p = .11). CONCLUSIONS Zinc supplementation is effective to decrease FPG, insulin, HOMA-IR and improve QUICKI in gestational diabetes, but has no significant impact on LDL-cholesterol and total cholesterol.
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Affiliation(s)
- Xiujuan Li
- Endocrinology Department, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinqiu Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Covali R, Socolov D, Socolov R. Coagulation tests and blood glucose before vaginal delivery in healthy teenage pregnant women compared with healthy adult pregnant women. Medicine (Baltimore) 2019; 98:e14360. [PMID: 30702627 PMCID: PMC6380794 DOI: 10.1097/md.0000000000014360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to compare the coagulation tests and blood glucose levels between healthy teenage pregnant patients and healthy adult pregnant patients just before vaginal deliveryIn a prospective study, 208 consecutive patients, 3rd trimester healthy pregnant women, underwent blood tests to determine their glucose levels the day before vaginal delivery. Of the 208 patients, 103 also underwent blood coagulation testing performed on the same day.The median values of the coagulation tests (APTT, prothrombin time, INR, prothrombin activity) and blood glucose were very similar in the healthy pregnant teenagers (32.6; 12.9; 1.02; 97.1; 81) compared with that in the healthy adult pregnant patients (32.45; 13.1; 1.01; 97.5; 81.2). Only the median value for fibrinogen was significantly different in healthy pregnant teenagers (348.9 mg/dL) (interquartile range 21.7) compared with that in healthy adult pregnant patients (359.1 mg/dL) (interquartile range 29.88).Significantly different median blood glucose levels also occurred in the <20; 20-29; 30-39; >40 age groups, but the glucose levels were still within normal limits.Even if there was variability between blood values from one age group to another, the median values for coagulation tests and blood glucose were very close in the healthy teenage pregnant patients compared with the median values of the healthy adult pregnant patients, just before vaginal delivery. With very few exceptions, the values for coagulation tests and blood glucose were within normal limits in all age groups of healthy pregnant patients.
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Affiliation(s)
- Roxana Covali
- Department of Radiology, Elena Doamna Obstetrics and Gynecology University Hospital
| | - Demetra Socolov
- Associate Professor, Department of Obstetrics and Gynecology, Cuza Voda Obstetrics and Gynecology University Hospital
| | - Razvan Socolov
- Associate Professor, Department of Obstetrics and Gynecology, Elena Doamna Obstetrics and Gynecology University Hospital, Iasi, Romania
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Skórzyńska-Dziduszko KE, Kimber-Trojnar Ż, Patro-Małysza J, Stenzel-Bembenek A, Oleszczuk J, Leszczyńska-Gorzelak B. Heat Shock Proteins as a Potential Therapeutic Target in the Treatment of Gestational Diabetes Mellitus: What We Know so Far. Int J Mol Sci 2018; 19:ijms19103205. [PMID: 30336561 PMCID: PMC6213996 DOI: 10.3390/ijms19103205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is a complex condition that involves a variety of pathological mechanisms, including pancreatic β-cell failure, insulin resistance, and inflammation. There is an increasing body of literature suggesting that these interrelated phenomena may arise from the common mechanism of endoplasmic reticulum (ER) stress. Both obesity-associated nutrient excess and hyperglycemia disturb ER function in protein folding and transport. This results in the accumulation of polypeptides in the ER lumen and impairs insulin secretion and signaling. Exercise elicits metabolic adaptive responses, which may help to restore normal chaperone expression in insulin-resistant tissues. Pharmacological induction of chaperones, mimicking the metabolic effect of exercise, is a promising therapeutic tool for preventing GDM by maintaining the body's natural stress response. Metformin, a commonly used diabetes medication, has recently been identified as a modulator of ER-stress-associated inflammation. The results of recent studies suggest the potential use of chemical ER chaperones and antioxidant vitamins as therapeutic interventions that can prevent glucose-induced ER stress in GDM placentas. In this review, we discuss whether chaperones may significantly contribute to the pathogenesis of GDM, as well as whether they can be a potential therapeutic target in GDM treatment.
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Affiliation(s)
| | - Żaneta Kimber-Trojnar
- Department of Obstetrics and Perinatology, Medical University of Lublin, K. Jaczewskiego 8 Street, 20-954 Lublin, Poland.
| | - Jolanta Patro-Małysza
- Department of Obstetrics and Perinatology, Medical University of Lublin, K. Jaczewskiego 8 Street, 20-954 Lublin, Poland.
| | - Agnieszka Stenzel-Bembenek
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, W. Chodźki 1 Street, 20-093 Lublin, Poland.
| | - Jan Oleszczuk
- Department of Obstetrics and Perinatology, Medical University of Lublin, K. Jaczewskiego 8 Street, 20-954 Lublin, Poland.
| | - Bożena Leszczyńska-Gorzelak
- Department of Obstetrics and Perinatology, Medical University of Lublin, K. Jaczewskiego 8 Street, 20-954 Lublin, Poland.
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Iron Status and Gestational Diabetes-A Meta-Analysis. Nutrients 2018; 10:nu10050621. [PMID: 29762515 PMCID: PMC5986501 DOI: 10.3390/nu10050621] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/30/2018] [Accepted: 05/11/2018] [Indexed: 12/21/2022] Open
Abstract
A meta-analysis of the association of iron overload with gestational diabetes mellitus (GDM) may inform the health debate. We performed a meta-analysis investigating the association of iron biomarkers and dietary iron exposure with GDM. We identified 33 eligible studies (N = 44,110) published in 2001–2017. The standardized mean differences (SMD) in women who had GDM compared to pregnant women without were 0.25 µg/dL (95% CI: 0.001–0.50) for iron, 1.54 ng/mL (0.56–2.53) for ferritin, 1.05% (0.02 to 2.08) for transferrin saturation, and 0.81 g/dL (0.40–1.22) for hemoglobin. Adjusted odds ratio for GDM were 1.58 (95% CI: 1.20–2.08) for ferritin, 1.30 (1.01–1.67) for hemoglobin, and 1.48 (1.29–1.69) for dietary heme intake. We did not find any differences in TIBC or transferrin concentration in women with and without GDM. We also did not find any association of increased transferrin receptor or increased intake of total dietary iron, non-heme iron or supplemental iron, with increased odds ratios for GDM. Considerable heterogeneity was present among the studies (0–99%), but no evidence of publication bias. Accumulating evidence suggests that circulating and dietary iron biomarkers among pregnant women are associated with GDM, but the results should be interpreted with caution due to the high heterogeneity of analyses. Randomized trials investigating the benefits of iron reduction in women at high risk for GDM are warranted.
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Sargın MA, Yassa M, Taymur BD, Celik A, Ergun E, Tug N. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy? Ther Clin Risk Manag 2016; 12:657-65. [PMID: 27217758 PMCID: PMC4853164 DOI: 10.2147/tcrm.s104247] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE We aimed to investigate whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) could be utilized to screen for gestational diabetes mellitus (GDM). SUBJECTS AND METHODS NLR and PLR were assessed by retrospective analysis of 762 healthy and pregnant women with GDM. The patients were stratified into four groups, as follows: GDM (n=144), impaired glucose tolerance (n=76), only screen positive (n=238), and control (n=304). RESULTS The leukocyte, neutrophil, and lymphocyte counts were significantly higher in the study groups compared with the control group (P=0.001; P<0.01). There were no statistically significant differences between the groups with respect to the NLR and PLR (P>0.05). CONCLUSION We do not recommend that blood NLR and PLR can be used to screen for GDM. However, increase in the leukocyte count is an important marker for GDM as it provides evidence of subclinical inflammation.
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Affiliation(s)
- Mehmet Akif Sargın
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Murat Yassa
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Bilge Dogan Taymur
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Ayhan Celik
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Emrah Ergun
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey
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12
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Sahbaz A, Cicekler H, Aynioglu O, Isik H, Ozmen U. Comparison of the predictive value of plateletcrit with various other blood parameters in gestational diabetes development. J OBSTET GYNAECOL 2016; 36:589-93. [PMID: 26758049 DOI: 10.3109/01443615.2015.1110127] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Gestational diabetes is the most encountered metabolic disease in pregnancy and affects both the mother and fetus adversely. Low-grade subchronic inflammation is associated with gestational diabetes development. Platelets (PLT) play role in blood coagulation and inflammatory process. We aimed to compare the various platelet indices in patients with GDM and healthy pregnant controls and to determine whether PLT indices are useful in Gestational diabetes diagnosis. The present study was performed at the Zonguldak Bulent Ecevit University, School of Medicine, Department of Obstetrics and Gynecology. Statistically significant relationships with plateletcrit, mean platelet volume, and platelet distribution width and patients with GDM were found (p < 0.001). Plateletcrit had higher sensitivity and specificity than other platelet indices. Although plateletcrit is a largely unknown or an underestimated parameter in complete blood count, it gives more precise information than platelet count and mean platelet volume. Platelet-related indices and their determination are inexpensive and routinely ordered markers, the significance of which is often ignored. They may be useful in screening for gestational diabetes as an adjunct to oral glucose tolerance test.
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Affiliation(s)
- Ahmet Sahbaz
- a Department of Obstetrics and Gynecology, School of Medicine , Zonguldak Bulent Ecevit University , Kozlu , Zonguldak , Turkey and
| | - Humeyra Cicekler
- b Department of Biochemistry , Zonguldak Ataturk Public Hospital , Zonguldak , Turkey
| | - Oner Aynioglu
- a Department of Obstetrics and Gynecology, School of Medicine , Zonguldak Bulent Ecevit University , Kozlu , Zonguldak , Turkey and
| | - Hatice Isik
- a Department of Obstetrics and Gynecology, School of Medicine , Zonguldak Bulent Ecevit University , Kozlu , Zonguldak , Turkey and
| | - Ulku Ozmen
- a Department of Obstetrics and Gynecology, School of Medicine , Zonguldak Bulent Ecevit University , Kozlu , Zonguldak , Turkey and
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Karamali M, Heidarzadeh Z, Seifati SM, Samimi M, Tabassi Z, Talaee N, Bahardoost H, Asemi Z. Zinc Supplementation and the Effects on Pregnancy Outcomes in Gestational Diabetes: a Randomized, Double-blind, Placebo-controlled Trial. Exp Clin Endocrinol Diabetes 2015; 124:28-33. [DOI: 10.1055/s-0035-1564146] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- M. Karamali
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, I.R. Iran
| | - Z. Heidarzadeh
- Department of Biology, Islamic Azad University, Ashkezar branch, Ashkezar, Iran
| | - S.-M. Seifati
- Department of Biology, Islamic Azad University, Ashkezar branch, Ashkezar, Iran
| | - M. Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Z. Tabassi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - N. Talaee
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - H. Bahardoost
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Z. Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
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14
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Gogeneni H, Buduneli N, Ceyhan-Öztürk B, Gümüş P, Akcali A, Zeller I, Renaud DE, Scott DA, Özçaka Ö. Increased infection with key periodontal pathogens during gestational diabetes mellitus. J Clin Periodontol 2015; 42:506-12. [PMID: 25959628 PMCID: PMC4699310 DOI: 10.1111/jcpe.12418] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 12/13/2022]
Abstract
AIM Gestational diabetes mellitus (GDM), gingivitis, infection with specific periodontal pathogens and systemic inflammation each increase the risk for poor pregnancy outcome. We set out to monitor the interactions of gingivitis and GDM with respect to oral infection and the systemic inflammatory burden. MATERIALS AND METHODS Four case-control groups (n = 117) were recruited, (1) No gingivitis, No GDM (n = 27); (2) Gingivitis, No GDM (n = 31); (3) No gingivitis, GDM (n = 21); and (4) Gingivitis, GDM (n = 38). Oral infection with three key periodontal pathogens was determined by PCR. Systemic inflammation was determined by quantification of CRP by EIA. RESULTS Gingivitis during pregnancy was associated with oral infection with Porphyromonas gingivalis, Filifactor alocis and Treponema denticola and combinations thereof (all p < 0.01). GDM was also associated with increased infection with individual and multiple oral pathogens (all p < 0.05). Gingivitis during pregnancy led to a 325% increase in systemic CRP (mean, 2495 versus 8116 ng/ml, p < 0.01). CONCLUSIONS Diabetes and gingivitis act in concert to increase risk biomarkers for poor pregnancy outcome.
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Affiliation(s)
- Himabindu Gogeneni
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Nurcan Buduneli
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Banu Ceyhan-Öztürk
- Department of Endocrine and Metabolic Diseases, Aydın State Hospital, Aydın, Turkey
| | - Pınar Gümüş
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Aliye Akcali
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Iris Zeller
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Diane E. Renaud
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - David A. Scott
- Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA
| | - Özgün Özçaka
- Periodontology, School of Dentistry, Ege University, Izmir, Turkey
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15
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Li C, Qiao B, Qi W, Zhan Y, Ma C, Zhao L, Li G. Association of Macrophage Migration Inhibitory Factor Polymorphisms with Gestational Diabetes Mellitus in Han Chinese Women. Gynecol Obstet Invest 2015; 81:84-9. [DOI: 10.1159/000398796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/06/2015] [Indexed: 11/19/2022]
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16
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Du M, Wang B, Liang Z, Dong M, Chen D. The Relationship between Retinol-Binding Protein 4 Concentrations and Gestational Diabetes Mellitus in Chinese Women. Gynecol Obstet Invest 2015; 81:000398794. [PMID: 25998178 DOI: 10.1159/000398794] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 04/06/2015] [Indexed: 02/28/2024]
Abstract
BACKGROUND This study aimed to investigate the relationship between retinol-binding protein 4 (RBP4) and gestational diabetes mellitus (GDM). METHODS Seventy-six women with and without GDM were recruited. Their blood samples were collected to detect RBP4, fasting plasma glucose (FPG), fasting insulin (Fins), triglyceride (TG), total cholesterol (TC), low-density lipoprotein, high-density lipoprotein (HDL) and glycosylated hemoglobin (HbA1c) levels. RESULTS RBP4 (21.42 ± 3.846 vs. 39.08 ± 8.293 μg/ml), FPG, Fins, homeostasis model assessment of insulin resistance (HOMA-IR), HbA1c, and TG levels were higher, while HDL levels were lower in women with GDM (p < 0.01). In healthy controls, RBP4 concentrations were positively correlated with HOMA-IR and TG and inversely correlated with FPG and HDL (p < 0.05). Serum concentrations of RBP4 in women with GDM were inversely correlated with TC and positively correlated with maternal weight gain during pregnancy (p < 0.05). The ROC curve was drawn with a correct rate of 93.4%. CONCLUSIONS Concentrations of serum RBP4 were significantly higher in women with GDM, suggesting that elevated RPB4 level may play a role in the pathogenesis of GDM. Meanwhile, RBP4 might be a good predictor of GDM. RBP4 is correlated with TG and HDL, indicating that RBP4 plays a role in alterations of lipid metabolism in pregnant women. © 2015 S. Karger AG, Basel.
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Affiliation(s)
- Mengkai Du
- Women's Hospital, School of Medicine, and Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, and Key Laboratory of Reproductive Health of Zhejiang Province, Hangzhou, China
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