Abstract
Aims Prevalence of gestational diabetes mellitus (GDM) may vary
across a country like India. Risk factors and disease-pathogenesis were also
not fully elucidated. This study aimed to examine prevalence of GDM among
pregnant women visiting antenatal clinic of a tertiary-care hospital of
Kolkata, India; possible mechanism of disease pathogenesis and potency of
associated parameters as disease biomarkers were also explored.
Methods 735 pregnant women were screened for GDM according to DIPSI
(Diabetes in Pregnancy Study Group India) guideline and risk-factors were
analyzed. Case-control study was conducted with 114 GDM and 114 matched
non-GDM control. Blood sample was collected before glucose load for complete
blood count, measurement of reactive oxygen species (ROS) and assessment of
DNA damage.
Results Prevalence of GDM was found to be
17.2%(127/735). Maternal age, diabetic family history and
acanthosis nigricans seemed to be important risk factors. Total ROS,
lymphocyte DNA damage (measured by comet-assay) and some inflammatory
hematological parameters were significantly higher in GDM compared to
control. ROS, comet-tail DNA%, WBC, neutrophil-lymphocyte ratio
(NLR) and mean platelet volume (MPV) were established as independent
determinants of disease condition after adjustment for pre-gestational body
mass index. In receiver operating characteristic analysis, ROS>155.7
arbitrary fluorescent unit, NLR>2.12 and
MPV>11.05 fL showed 82.5 & 98.2%, 71.9
& 84.2% and 71.9 & 82.5% sensitivity
& specificity respectively in disease prediction.
Conclusions Prevalence of GDM seemed to be high in Kolkata on Indian
scenario. Oxidative-stress, related DNA-damage and inflammation seemed to
have important contribution in pathogenesis of GDM independent of obesity.
ROS, NLR and MPV with respective cut-off scores might be used as diagnostic
and prognostic biomarkers for better management of the disease.
Maternal and perinatal outcome in gestational diabetes mellitus in a Tertiary Care Hospital in Delhi
