Unique Biomarker Characteristics in Gestational Diabetes Mellitus Identified by LC-MS-Based Metabolic Profiling

Background. Gestational diabetes mellitus (GDM) is a type of glucose intolerance disorder that first occurs during women’s pregnancy. The main diagnostic method for GDM is based on the midpregnancy oral glucose tolerance test. The rise of metabolomics has expanded the opportunity to better identify early diagnostic biomarkers and explore possible pathogenesis. Methods. We collected blood serum from 34 GDM patients and 34 normal controls for a LC-MS-based metabolomics study. Results. 184 metabolites were increased and 86 metabolites were decreased in the positive ion mode, and 65 metabolites were increased and 71 were decreased in the negative ion mode. Also, it was found that the unsaturated fatty acid metabolism was disordered in GDM. Ten metabolites with the most significant differences were selected for follow-up studies. Since the diagnostic specificity and sensitivity of a single differential metabolite are not definitive, we combined these metabolites to prepare a ROC curve. We found a set of metabolite combination with the highest sensitivity and specificity, which included eicosapentaenoic acid, docosahexaenoic acid, docosapentaenoic acid, arachidonic acid, citric acid, α-ketoglutaric acid, and genistein. The area under the curves (AUC) value of those metabolites was 0.984 between the GDM and control group. Conclusions. Our results provide a direction for the mechanism of GDM research and demonstrate the feasibility of developing a diagnostic test that can distinguish between GDM and normal controls clearly. Our findings were helpful to develop novel biomarkers for precision or personalized diagnosis for GDM. In addition, we provide a critical insight into the pathological and biological mechanisms for GDM.

Download Full-text

Serum magnesium and copper levels in Bangladeshi women with gestational diabetes mellitus

IMC Journal of Medical Science ◽

10.3329/imcjms.v11i1.31935 ◽

2017 ◽

Vol 11 (1) ◽

pp. 25-28

Author(s):

Farzana Akonjee Mishu ◽

MA Muttalib

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Medical College Hospital ◽

Control Group ◽

Oral Glucose ◽

Third Trimester ◽

College Hospital ◽

Medical College

Background and objectives: Alteration of magnesium (Mg) and copper (Cu) concentrations in blood has been observed in normal pregnancy as well as in gestational diabetes mellitus (GDM). The present study was aimed to evaluate the serum Mg and Cu levels in Bangladeshi women with GDM in their second and third trimester of pregnancy.Methods: The study was conducted at Mymensingh Medical College Hospital from July 2013 to June 2014. Pregnant women, in their second and third trimester, attending the outpatient department of Obstetrics and Gynecology and the Department of Endocrinology of Mymensingh Medical College Hospital were enrolled by purposive sampling technique. GDM was diagnosed on the basis of oral glucose tolerance test (OGTT) as defined in WHO criteria 2013. Blood glucose was estimated by enzymatic GOD-PAP colorimetric method. The cut off value for fasting plasma glucose level was ?6.1 mmol/L or ?7.8 mmol/L 2 hours after glucose load. Serum Cu was estimated by 3, 5-DiBr-PAESA method and Mg by Xylidyl Blue-I Method as per manufacturers instruction.Results: A total of 172 pregnant women in their second and third trimester were enrolled. Out of 172 participants, 86 had GDM and 86 were normoglycemic (control). The mean age of GDM and control groups was 28.6±3.2 years and 27.3±3.1 years respectively. The BMI was 26.4±1.5 m/kg2 and 26.3±1.3 m/kg2. Serum Mg level was significantly low (p< 0.001) in 2nd and 3rd trimesters in GDM cases (1.39±0.26 mg/dl and 0.93±0.15 mg/dl) compared to control group (1.67±0.3 mg/dl and 1.67±0.31mg/dl). On the contrary, serum Cu levels in GDM cases were significantly (p<0.002) higher in both trimesters (224±333.8 ?g/dl and 243.91±6.89 ?g/dl) compared to those without GDM (220.1±7.6 ?g/dl and 234.9±4.6 ?g/dl). There was significant (p<0.001) increase of serum Cu levels in 3rd trimester compared to 2nd trimester in both GDM and non GDM cases.Conclusion: There was distinct alteration of serum Mg and Cu levels in GDM compared to normal pregnancy.IMC J Med Sci 2017; 11(1): 25-28

Download Full-text

The associations of incretin hormone concentration with gestational diabetes mellitus

Diabetes Mellitus ◽

10.14341/dm2004134-37 ◽

2016 ◽

Vol 19 (2) ◽

pp. 150-157 ◽

Cited By ~ 2

Author(s):

Tatiana V. Saprina ◽

Ekaterina S. Timokhina ◽

Olga K. Goncharevich ◽

Svetlana V. Budeeva ◽

Tatiana S. Prokhorenko ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Carbohydrate Metabolism ◽

Hormone Secretion ◽

Control Group ◽

Oral Glucose ◽

Incretin Hormone ◽

Metabolism Disorder

Background: Enteropancreatic hormonal system disorder is a possible reason for β-cell dysfunction and carbohydrate metabolism disorder among pregnant women. However, no information is available about the state of enteroinsulin hormones [glucagon, glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide1 (GLP-1) and GLP-2] during pregnancy. The role of enteroinsulin hormones in the development of carbohydrate metabolism disorder during pregnancy is poorly understood. Aim: To quantify and compare incretin hormone secretion in groups of pregnant women with and without gestational diabetes mellitus (GDM). Materials and methods: The study included 80 patients, 50 of whom had GDM, and the control group consisted of 30 pregnant women without GDM. All patients underwent an oral glucose tolerance test; glycated haemoglobin (HbA1c) estimation; ferritin, transferrin, basal and postprandial glucagon estimation; GLP-1 and GLP-2 estimation. Results: Basal glucagon and GLP-1 levels were significantly higher (p 0. 05) in the group of women with GDM than in the control group. The most significant differences in GLP-1, basal and postprandial glucagon levels were observed during the first trimester of pregnancy. Conclusion: High GLP-1 levels in the group of women with GDM may reflect a state of ‘incretin resistance’, which is similar to hyperinsulinemia in the early stages of type 2 diabetes mellitus.

Download Full-text

Prospective of study of gestational diabetes mellitus risk in relation to maternal recreation physical activity before and after pregnancy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183270 ◽

2018 ◽

Vol 6 (8) ◽

pp. 2785

Author(s):

Sukesh R. S. ◽

Laxmy Rajmohan

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Challenge Test ◽

Control Group ◽

Case Group ◽

Oral Glucose ◽

Family History Of Diabetes ◽

Pregnant Females

Background: Gestational diabetes mellitus is common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. The present study aimed to know association between physical activity and gestational diabetes mellitus in the first 20 weeks of their pregnancy.Methods: In the current case-control study, 50 pregnant females with gestational diabetes mellitus as the case group and 50 pregnant females as control group were selected. To diagnose gestational diabetes mellitus using diagnostic criteria. Females with abnormal oral glucose challenge test (>140mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by pregnancy physical activity questionnaire. Anthropometric and other data were recorded for all of the participants.Results: Females with low total physical activity at early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus compared to the ones with higher levels of physical activity. After adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. Females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus compared to females with a higher intensity of sedentary, light and moderate physical activity.Conclusions: Females should be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it.

Download Full-text

Risk of gestational diabetes mellitus: which lifestyle parameters should be changed?

Diabetes Mellitus ◽

10.14341/dm8226 ◽

2017 ◽

Vol 20 (1) ◽

pp. 85-92

Author(s):

Polina Viktorovna Popova ◽

Aleksandra Sergeevna Tkachuk ◽

Yana Alexeevna Bolotko ◽

Andrey Sergeevich Gerasimov ◽

Ksenia Alexandrovna Demidova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Tolerance Test ◽

Control Group ◽

Oral Glucose ◽

Food Groups ◽

Dried Fruits ◽

Iadpsg Criteria ◽

Quantitative Manner

Background. Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It can cause significant problems for the mother and offspring, such as caesarean delivery, birth trauma and the development of type 2 diabetes mellitus (T2DM) in the future. The identification and correction of modifiable risk factors for GDM will provide a possibility to prevent these complications. Aim. This study aimed to identify the most significant lifestyle parameters affecting the risk of developing GDM. Methods. The study included 680 pregnant women who underwent oral glucose tolerance test at 2432 weeks of pregnancy and responded to a questionnaire comprising the following sections stratified in a semi-quantitative manner: the consumption of major food groups and drinks and the amount of physical activity and smoking before and during pregnancy. A logistic regression analysis was performed to identify lifestyle parameters that influence GDM development. GDM was diagnosed according to the IADPSG criteria. Results. GDM was diagnosed in 266 women; the other 414 women formed the control group. The most significant dietary risk factor for developing GDM was the consumption of sausage(s), dried fruits and fresh fruits. Eating sausage(s) more than thrice a week during pregnancy increased the risk of developing GDM by 2.4 times [95% confidence interval (CI), 1.53.8; p 0.001] and so did the consumption of dried fruits more than thrice a week during pregnancy [odds ratio (OR), 6.5; 95% CI, 2.516.8; p 0.001)] compared with the risk of GDM by less consumption of these food groups. A regular consumption of fresh fruits more than 12 times a week during pregnancy reduced the risk of GDM (OR, 0.5; 95% CI, 0.30.8; p = 0.015). The habit of climbing at least four floors per day during pregnancy also reduced the risk of GDM (OR, 0.7; 95% CI, 0.51.0; p = 0.069). Conclusions. The recommendations for GDM prevention should include limiting the consumption of sausage(s) and dried fruits, increasing the consumption of fresh fruits and introducing regular physical activities, such as climbing stairs.

Download Full-text

Plasma Zonulin Levels as a Non-Invasive Biomarker of Intestinal Permeability in Women with Gestational Diabetes Mellitus

Biomolecules ◽

10.3390/biom9010024 ◽

2019 ◽

Vol 9 (1) ◽

pp. 24 ◽

Cited By ~ 7

Author(s):

Esra Demir ◽

Hanise Ozkan ◽

Kerem Doga Seckin ◽

Berrak Sahtiyancı ◽

Bulent Demir ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Intestinal Permeability ◽

Large Scale ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Oral Glucose ◽

Model Assessment ◽

Non Invasive

Objective: We aimed to compare the levels of plasma zonulin, a non-invasive biomarker of increased intestinal permeability, between pregnant subjects, with and without gestational diabetes mellitus (GDM), at 24–28 gestational weeks. The eighty-five consecutive pregnant subjects that presented to our hospital’s obstetrics outpatient clinic and were diagnosed with GDM, for the first time by an oral glucose tolerance test (OGTT), formed the GDM group; 90 consecutive subjects that were not diagnosed with GDM by OGTT, formed the control group. The diagnosis of GDM was made by an OGTT performed between the 24th and 28th weeks of gestation, and in compliance with the American Diabetes Association (ADA) criteria. Plasma zonulin levels were measured by the enzyme-linked immunosorbent assay (ELISA) methods. The Plasma zonulin level was significantly higher in the GDM group than the control group (p < 0.001). A correlation analysis showed that plasma zonulin level was positively correlated to body mass index (BMI), creatinine, fasting plasma glucose, baseline, first hour, and two hours glucose levels and the OGTT, hemoglobin A1C (HbA1C), homeostatic model assessment for insulin resistance (HOMA-IR), and alanine aminotransferase (ALT) levels. Our findings suggest that zonulin may be a non-invasive biomarker involved in the pathogenesis of GDM. Further large-scale studies are needed on this subject.

Download Full-text

Awareness of gestational diabetes mellitus foetal-maternal risks: an Italian cohort study on pregnant women

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04172-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Paola Quaresima ◽

Federica Visconti ◽

Fabiana Interlandi ◽

Luigi Puccio ◽

Patrizia Caroleo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Treatment Group ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Control Group ◽

P Value ◽

Oral Glucose ◽

Level Of Education ◽

The Impact

Abstract Background Gestational diabetes mellitus (GDM) incidence is increasing worldwide. It represents a major risk factor for adverse foetal-maternal outcomes. Awareness among women in regard to GDM-related risks (in particular foetus ones) has been proven to have an impact on compliance with recommendations. Therefore we aimed to evaluate the efficacy of our post-diagnosis counselling, that informs affected women of the GDM related risks for complications, in determining an adequate level of understanding. Method This is a cohort study involving 400 women undergoing the 24-28 weeks 75 g oral glucose tolerance test. Two hundred women diagnosed with GDM received the post-diagnosis counselling (treatment group) and two hundred women diagnosed without did not receive any counselling (control group). Both populations were surveyed with a 5 question questionnaire regarding their awareness about GDM foetal-maternal related risks. Their level of education about GDM foetal-maternal related risks, estimated according to the number of correct answers, was scored as: primary (score 0-1), secondary (score 2-3) or tertiary (score 4-5). Results Most of the women in the treatment group after receiving the post-diagnosis counselling have demonstrated a secondary level of education 132/200 (66%). Their mean level of awareness was higher in comparison to the control group 2.6 ± 1.8 (SD) versus 2.14 ± 1.8 (SD) p value = 0.012. In particular, they’ve demonstrated to be more aware of the risks for the foetus to become macrosomic (p = 0.004) or to die in utero (p = 0.0001). A high level of education and to have had previous pregnancies positively affected correct answers. Conclusions Our post-diagnosis counselling has played a role in improving women awareness about GDM foetal-maternal related risks. Future study will explore the impact of women’s level of awareness on glycaemic control.

Download Full-text

Ameliorative potential of acupressure on gestational diabetes mellitus: A randomized controlled trial

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2018-0011 ◽

2018 ◽

Vol 16 (1) ◽

Author(s):

Fayiz F. El-Shamy ◽

Sanad S. El-Kholy ◽

Mahmoud Labib ◽

Ahmed M. Kabel

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Antenatal Care ◽

Controlled Trial ◽

Neonatal Outcomes ◽

Control Group ◽

Oral Glucose ◽

Female Patients

Abstract Background and aim Gestational diabetes mellitus (GDM) poses a threat to the mother and child. The aim of this study was to examine the effect of acupressure on the glycemic control and insulin requirement of GDM females. Materials and methods Thirty GDM female patients were randomized to either the study group (SG; n=15), which was treated with acupressure and the standard antenatal care, or the control group (CG; n=15), which was treated with the standard antenatal care. Fasting and 2-h post-prandial blood glucose levels, requirement for insulin and insulin resistance were measured at 24 and 36 weeks’ gestation (WG). Also, neonatal outcomes were registered at delivery. Results The pre intervention showed no statistically significant differences between SG and CG for baseline characteristics of participants (p>0.05). Within group analyses, after 12 weeks intervention had shown that 75 g oral glucose tolerance test (OGTT), insulin resistance, number of required insulin and measure of utilized insulin were significantly reduced (p<0.05), with significant increase in body mass index (BMI) (p<0.05) in both groups. All outcome measures were not significantly changed (p>0.05) between both groups at 24 and 36 WG. No significant differences (p>0.05) in pregnancy and neonatal outcomes between both groups at labor. Conclusions Acupressure may help to reduce gestational diabetes or insulin treatment for overweight female patients with GDM.

Download Full-text

Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus

Current Diabetes Reviews ◽

10.2174/1573399816666191223111833 ◽

2020 ◽

Vol 16 (8) ◽

pp. 895-899 ◽

Cited By ~ 1

Author(s):

Shahin Safian ◽

Farzaneh Esna-Ashari ◽

Shiva Borzouei

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Thyroid Dysfunction ◽

Control Group ◽

Thyroid Peroxidase ◽

Free T4 ◽

Significant Difference ◽

Experimental Group

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.

Download Full-text

The Association between Maternal/Fetal Insulin Receptor Substrate 1 Gene Polymorphism rs1801278 and Gestational Diabetes Mellitus in a Chinese Population

Gynecologic and Obstetric Investigation ◽

10.1159/000514971 ◽

2021 ◽

pp. 1-8

Author(s):

Lingling Wu ◽

Changping Fang ◽

Jun Zhang ◽

Yanchou Ye ◽

Haiyan Zhao

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gene Polymorphism ◽

Gestational Diabetes Mellitus ◽

Insulin Receptor ◽

Tolerance Test ◽

Oral Glucose ◽

Insulin Receptor Substrate ◽

Single Center ◽

Insulin Receptor Substrate 1

Objectives: Insulin receptor substrate 1 (IRS1) is a crucial factor in the insulin signaling pathway. IRS1 gene polymorphism rs1801278 in mothers has been reported to be associated with gestational diabetes mellitus (GDM). However, it is not clear whether IRS1 gene polymorphism rs1801278 in fetuses is associated with their mothers’ GDM morbidity. The purpose of this study is to analyze the association between maternal, fetal, or maternal/fetal IRS1 gene polymorphism rs1801278 and GDM risk. Design: The study was a single-center, prospective cohort study. In total, 213 pairs of GDM mothers/fetuses and 191 pairs of control mothers/fetuses were included in this study. They were recruited after they underwent oral glucose tolerance test during 24–28 weeks of gestation and followed up until delivery. All participants received the conventional interventions (diet and exercise), and no special therapy except routine treatment. Methods: A total of 213 pairs of GDM mothers/fetuses and 191 pairs of normal blood glucose pregnant mothers/fetuses were genotyped using PCR and DNA sequencing from January 2015 to September 2016. Maternal/fetal IRS1 gene polymorphism rs1801278 was analyzed and compared between 2 groups. Results: There were no significant differences in the frequency of individual mothers’ or fetuses’ IRS1 rs1801278 polymorphisms between 2 groups; if both the mothers and fetuses carried A allele, significantly lower GDM morbidity was observed in the mothers. Limitations: The sample size was relatively small as a single-center study. Conclusions: Our study suggested that maternal/fetal rs1801278 polymorphism of IRS1 is a modulating factor in GDM; both mothers/fetuses carrying the A allele of rs1801278 may protect the mothers against the development of GDM.

Download Full-text

Breastfeeding Duration and Development of Dysglycemia in Women Who Had Gestational Diabetes Mellitus: Evidence from the GUSTO Cohort Study

Nutrients ◽

10.3390/nu13020408 ◽

2021 ◽

Vol 13 (2) ◽

pp. 408

Author(s):

Sumali S. Hewage ◽

Xin Yu Hazel Koh ◽

Shu E. Soh ◽

Wei Wei Pang ◽

Doris Fok ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Tolerance Test ◽

Diabetes Risk ◽

Breastfeeding Duration ◽

Oral Glucose ◽

Inverse Association ◽

Index Pregnancy

(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). (3) Results: Women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). (4) Conclusions: Our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.

Download Full-text