scholarly journals Triglyceride glycemic index as a biomarker for gestational diabetes mellitus: a systemic review and meta-analysis

2021 ◽  
Author(s):  
Yusen Liu ◽  
Ruiwen Chi ◽  
Yujie Jiang ◽  
Bicheng Chen ◽  
Youli Chen ◽  
...  

Background: Triglyceride glycemic (TyG) index is a novel tool for assessing insulin resistance (IR). Recently, TyG index as a potential biomarker for gestational diabetes mellitus (GDM) has been studied, but its performance is yet inconclusive. Thus, we performed this systemic review and meta-analysis to evaluate the performance of TyG index in predicting GDM. Methods: Studies published before March 1st, 2021 with comparison of TyG index between GDM patients and healthy controls were retrieved from multiple databases (PubMed, Web of Science, The Cochrane Library and Embase). The mean difference (MD) of TyG index in GDM patients and healthy controls were pooled using random-effect models. Results: Differentiation of TyG index between patients with GDM and controls showed significant results. Overall, there is a four-fold increase in TyG index in GDM patients compared with controls (MD: 0.22, 95%CI: 0.07 - 0.36, p = 0.003; I2 = 71%, p = 0.009). In subgroup analyses according to gestational time, TyG index in the second trimester predicted GDM with low heterogeneity (MD: 0.26, 95%CI: 0.15 - 0.37, p < 0.001; I2 = 0%, p = 0.54), while no such correlation was found in the first trimester. Conclusion: TyG index, especially in the second trimester, could be a promising biomarker for predicting GDM.

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Zhongwei Zhou ◽  
Hongmei Chen ◽  
Mingzhong Sun ◽  
Huixiang Ju

Aim. To evaluate the association between mean platelet volume (MPV) and gestational diabetes mellitus (GDM). Methods. A systematic literature search was performed in PubMed, EMBASE, Web of Science, and The Cochrane Library up to 4 September 2017. Pooled standardized mean differences (SMD) and 95% confidence interval (CI) were calculated using a random-effect model. Results. Nineteen studies comprising 1361 GDM patients and 1911 normal pregnant women were included. MPV was increased in GDM patients when compared with healthy pregnant women (SMD: 0.79; 95% CI: 0.43–1.16; P<0.001). Subgroup analyses revealed that such trend was consistent in the third-trimester (SMD: 1.35; 95% CI: 0.72–1.98), Turkish (SMD: 0.81; 95% CI: 0.43–1.19), and Italian (SMD: 2.78; 95% CI: 2.22–3.34) patients with GDM and the patients diagnosed based on Carpenter and Coustan criteria (SMD: 1.04; 95% CI: 0.42–1.65). Significantly higher MPV also were observed within cross-sectional studies (SMD: 0.99; 95% CI: 0.49–1.49). Remarkable between-study heterogeneity and potential publication bias were observed in this meta-analysis; however, sensitivity analysis indicated that the results were not unduly influenced by any single study. Conclusions. GDM patients are accompanied by increased MPV, strengthening the clinical evidence that MPV may be a predictive marker for GDM.


Author(s):  
Mohamed H. ELSHAHIDI

Background: During the past 20 years, the prevalence of gestational diabetes mellitus (GDM) has increased by ∼10%-100% in several race/ethnicity groups. There is an association between ambient air pollution (AAP) and GDM. This study aimed to summarize the evidence about the association between AAP and GDM. Methods: PubMed, Embase, Scopus, Web of Science and Cochrane Library were searched from inception till Oct 2017. Studies about the association between ambient air pollutants levels and GDM were included. Pooled effect estimates and their 95% confidence interval (CI) were calculated using R. Results: Eight studies met the inclusion criteria. The odds of developing GDM upon exposure to CO (per 1 ppm), NO (per 1 ppb), NO2 (per 10 µg/m3), NOx (per 1 ppb), O3 (per 10 ppb), SO2 (per 10 ppb), PM10 (per 10 µg/m3) and PM2.5 (per 10 µg/m3) were 1.47 (95% CI 0.88-2.06), 1.04 (95% CI 1.03-1.06), 1 (95% CI 0.93-1.08), 1.02 (95% CI 1-1.04), 1.05 (95% CI 0.94-1.16), 1.39 (95% CI 1.04-1.73), 0.97 (95% CI 0.94-0.99) and 1.12 (95% CI 0.93-1.31), respectively. Conclusion: The current literature showed evidence for an association between AAP and GDM. However, further well-designed studies are needed.


2019 ◽  
Vol 2019 ◽  
pp. 1-29 ◽  
Author(s):  
Lanlan Guo ◽  
Jing Ma ◽  
Jia Tang ◽  
Dingyao Hu ◽  
Wei Zhang ◽  
...  

To compare the efficacy and safety of metformin, glyburide, and insulin in treating gestational diabetes mellitus (GDM), a meta-analysis of randomized controlled trials (RCTs) was conducted. PubMed, Embase, CINAHL, Web of Science, and Cochrane Library to November 13, 2018, were searched for RCT adjusted estimates of the efficacy and safety of metformin, glyburide, and insulin treatments in GDM patients. There were 41 studies involving 7703 GDM patients which were included in this meta-analysis; 12 primary outcomes and 24 secondary outcomes were detected and analyzed. Compared with metformin, insulin had a significant increase in the risk of preeclampsia (RR, 0.57; 95% CI, 0.45 to 0.72; P<0.001), NICU admission (RR, 0.75; 95% CI, 0.64 to 0.87; P<0.001), neonatal hypoglycemia (RR, 0.57; 95% CI, 0.49 to 0.66; P<0.001), and macrosomia (RR, 0.68; 95% CI, 0.55 to 0.86; P<0.05). To the outcomes of birth weight and gestational age at delivery, insulin had a significant increase when compared with metformin (MD, 114.48; 95% CI, 37.32 to 191.64; P<0.01; MD, 0.23; 95% CI, 0.12 to 0.34; P<0.001; respectively). Of the two groups between glyburide and metformin, metformin had lower gestational weight gain compared with glyburide (MD, 1.67; 95% CI, 0.26 to 3.07; P<0.05). Glyburide had a higher risk of neonatal hypoglycemia compared with insulin (RR, 1.76; 95% CI, 1.32 to 2.36; P<0.001). This meta-analysis found that metformin could be a safe and effective treatment for GDM. However, clinicians should pay attention on the long-term offspring outcomes of the relative data with GDM patients treated with metformin. Compared with insulin, glyburide had a higher increase of neonatal hypoglycemia. The use of glyburide in pregnancy for GDM women appears to be unclear.


2020 ◽  
pp. 1-10
Author(s):  
Z. Wang ◽  
I.C.K. Wong ◽  
K.K.C. Man ◽  
B.H. Alfageh ◽  
P. Mongkhon ◽  
...  

Abstract Background Previous studies have found contradicting results with regard to the use of antipsychotics during pregnancy and the risk of gestational diabetes mellitus (GDM). We aimed to evaluate the association between antipsychotic use in pregnancy and GDM. Methods A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Cochrane Library databases up to March 2019, for data from observational studies assessing the association between gestational antipsychotic use and GDM. Non-English studies, animal studies, case reports, conference abstracts, book chapters, reviews and summaries were excluded. The primary outcome was GDM. Estimates were pooled using a random effect model, with the I2 statistic used to estimate heterogeneity of results. Our study protocol was registered with PROSPERO number: CRD42018095014. Results In total 10 cohort studies met the inclusion criteria in our systematic review with 6642 exposed and 1 860 290 unexposed pregnancies. Six studies were included in the meta-analysis with a pooled adjusted relative risk of 1.24 overall [95% confidence interval (CI) 1.09–1.42]. The I2 result suggested low heterogeneity between studies (I2 = 6.7%, p = 0.373). Conclusion We found that the use of antipsychotic medications during pregnancy is associated with an increased risk of GDM in mothers. However, the evidence is still insufficient, especially for specific drug classes. We recommend more studies to investigate this association for specific drug classes, dosages and comorbidities to help clinicians to manage the risk of GDM if initiation or continuation of antipsychotic prescriptions during pregnancy is needed.


2018 ◽  
Vol 5 (3) ◽  
pp. 2078-2095
Author(s):  
Shahin Nargesi ◽  
Ayub Ghorbani ◽  
Ehsan Shirzadpour ◽  
Mahmoud Mohamadpour ◽  
Seyedeh Fatemeh Mousavi ◽  
...  

Introduction: Vitamin D deficiency has become quite prevalent and is known to cause a great many diseases. Numerous studies have investigated the association between vitamin D deficiency and gestational diabetes, and the results are somewhat contradictory. The present study deals with the relationship between the vitamin D deficiency and gestational diabetes. Methods: Two researchers made use of MeSH, Scopus, PubMed database, Science Direct, the Cochrane Library, the Web of Science, CINAHL, and Google Scholar search engines to identify qualified studies and articles carried out and published before August 2017 and reported the risk of gestational diabetes developing as a result of vitamin D deficiency. The association between the two conditions was measured using odds ratios (ORs) with 95% confidence intervals (CIs). Funnel plots, Egger’s, and Begg’s tests were also used to assess publication bias. All analysis was done by STATA (version 11.2). Results: Twenty-nine eligible studies with a total of 14,497 participants were included in the final analysis. Overall, maternal vitamin D insufficiency was significantly associated with a greater risk of gestational diabetes (OR = 1.15; 95% CI, 1.00-1.30; p<0.001). Serum 25OHD was significantly lower in participants with gestational diabetes mellitus than in those with natural glucose tolerance (−29.7 nmol/L, 95% CI, −36.6 to −22.8; p=0.000). Conclusion: According to the current meta-analysis results, vitamin D deficiency is correlated with the risk of gestational diabetes development.


2021 ◽  
Vol 12 ◽  
Author(s):  
Samira Behboudi-Gandevani ◽  
Razieh Bidhendi-Yarandi ◽  
Mohammad Hossein Panahi ◽  
Mojtaba Vaismoradi

ObjectivesIt is uncertain whether the treatment of mild gestational diabetes mellitus (GDM) improves pregnancy outcomes. The aim of this systemic review and meta-analysis was to investigate the effect of mild GDM treatment on adverse pregnancy outcomes.MethodsA comprehensive literature search was conducted on the databases of PubMed, Scopus, and Google Scholar to retrieve studies that compared interventions for the treatment of mild GDM with usual antenatal care. The fixed/random effects models were used for the analysis of heterogeneous and non-heterogeneous results. Publication bias was assessed using the Harbord test. Also, the DerSimonian and Laird, and inverse variance methods were used to calculate the pooled odds ratio of events. The quality assessment of the included studies was performed using the Modified Newcastle–Ottawa Quality Assessment scale and the CONSORT checklist. In addition, the risk of bias was evaluated using the Cochrane Collaboration’s tool for assessing risk of bias.ResultsThe systematic review and meta-analysis involved ten studies consisting of 3317 pregnant women who received treatment for mild GDM and 4407 untreated counterparts. Accordingly, the treatment of mild GDM significantly reduced the risk of macrosomia (OR = 0.3; 95%CI = 0.3–0.4), large for gestational age (OR = 0.4; 95%CI = 0.3–0.5), shoulder dystocia (OR = 0.3; 95%CI = 0.2–0.6), caesarean-section (OR = 0.8; 95%CI = 0.7–0.9), preeclampsia (OR = 0.4; 95%CI = 0.3–0.6), elevated cord C-peptide (OR = 0.7; 95%CI = 0.6–0.9), and respiratory distress syndrome (OR = 0.7; 95%CI = 0.5–0.9) compared to untreated counterparts. Moreover, the risk of induced labor significantly increased in the treated group compared to the untreated group (OR = 1.3; 95%CI = 1.0–1.6). However, no statistically significant difference was observed between the groups in terms of small for gestational age, hypoglycemia, hyperbilirubinemia, birth trauma, admission to the neonatal intensive care unit, and preterm birth. Sensitivity analysis based on the exclusion of secondary analysis data was all highly consistent with the main data analysis.ConclusionTreatment of mild GDM reduced the risk of selected important maternal outcomes including preeclampsia, macrosomia, large for gestational age, cesarean section, and shoulder dystocia without increasing the risk of small for gestational age. Nevertheless, the treatment could not reduce the risk of neonatal metabolic abnormalities or several complications in newborn.


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