Abstract
Background: Neuregulin4 (NGR4) is a brown fat adipokine that modulates carbohydrate and lipid metabolism, regulate insulin sensitivity. The relationship between NGR4 and gestational diabetes mellitus (GDM) remains unclear due to discrepancy in studies. The objective of this study was to find out association between NRG4 and insulin level in women with GDM and their relationship with other metabolic parameters. Methods: In this comparative cross sectional study, pregnant women (n=80), coming for regular antenatal check-ups between 24 and 28 weeks of gestation were recruited. After informed signed consent, interview based proforma was filled with demographic data and antenatal history. Anthropometric measurements were taken; weight recorded on first visit was considered pre-pregnancy weight. Blood (5ml) was drawn after 12 hours fast for estimation of fasting blood sugar (FBS), insulin, NRG4 and lipid profile and secondly after one hour post-consuming 50gm glucose, for glucose challenge test. Statistical analysis was done using SPSS version20, Mann Whitney and Spearman correlation for finding association between variables, whereas, Kruscal Wallis Test for differences between groups. Results: Median NRG4 level (0.98) in healthy group was significantly high (p<0.038) compared to GDM (0.94). The NRG4 had inverse weak association with GDM. The mean insulin and homeostasis assessment model of insulin resistance (HOMA IR) values had weak direct association with NRG4. Cholesterol, LDL had inverse relationship with NRG4. All parameters of lipid profile were high in GDM compared to non GDM, but only cholesterol was statistically significant (p<0.03). The FBS in healthy group was significantly low (p<0.02) compared to GDM. The association between insulin and HOMA IR was statistically significant (p<0.05). The difference between BMI was statistically significant with age (p<0.015), parity (p<0.035). The difference between FBS and education was found significant (p<0.049). Conclusion: Serum NRG4 level were found low in GDM compared to non-GDM (p<0.03), with a week and direct association with insulin. Future studies are required with bigger sample size to establish NRG4 as a potential biomarker for GDM.
Corrigendum to “A composite risk assessment model to screen for gestational diabetes mellitus among Mediterranean women” [Int J Gynecol Obstet 120 (2013) 240-244]
