scholarly journals High Level of Complement Factor Ba Within 11 to 17 Weeks of Gestation Increases the Risk of Subsequent Gestational Diabetes: A Propensity Score-Matched Study

Author(s):  
Ying Shen ◽  
Junxian Li ◽  
Hairong Tian ◽  
Ye Ji ◽  
Ziyun Li ◽  
...  

Abstract Background: Several studies have shown that the over activation of complement factor B(CFB) was related to obesity, insulin resistance(IR) and type 2 diabetes mellitus. This study was to assess whether circulating complement factor Ba (CFBa) within 11 to 17 weeks of gestation is associated with subsequent gestational diabetes mellitus (GDM) or not.Methods: Biochemical parameters and blood samples were collected from 399 pregnant women within 11 to 17 weeks of gestation. At 24 to 28 weeks of pregnancy, all participants underwent 75-g oral glucose tolerance test (fasting for more than 8 hours before blood sampling) and were assigned to GDM group(n=80) and normal control group(n=319). Perinatal data were collected after delivery. A propensity score-matched (PSM) analysis was performed to reduce the impact of confounding factors on glucose metabolism during pregnancy between the two groups.Results: Two groups of 74 well-matched patients who maintained balance in terms of baseline characteristics. The levels of CFBa in pregnant women who later developed GDM were significantly higher than those in healthy pregnant women [0.4(0.1-0.8) vs. 0.2(0.2-0.3), P=0.031]. Logistic regression results confirmed that the level of CFBa was an independent influencing factor for the occurrence of GDM (OR=1.52, 95% CI: 1.25-1.85, P=0.000). Further grouping according to the quartile of CFBa level, it was found that the incidence of GDM in category 3 was markedly higher than that in the first and the second categories. Conclusions: High level of the CFBa within 11 to 17 weeks of gestation increased the risk of subsequent GDM, and maybe a biomarker for predicting GDM.

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Chadakarn Phaloprakarn ◽  
Siriwan Tangjitgamol

Abstract Background Blood glucose levels during pregnancy may reflect the severity of insulin secretory defects and/or insulin resistance during gestational diabetes mellitus (GDM) pregnancy. We hypothesized that suboptimal glycemic control in women with GDM could increase the risk of postpartum type 2 diabetes mellitus (T2DM) or prediabetes. Our objective was to evaluate the impact of plasma glucose levels throughout GDM pregnancy on the risk of postpartum T2DM or prediabetes. Methods The medical records of 706 women with GDM who underwent a postpartum 75-g, 2-hour oral glucose tolerance test at our institution between January 2011 and December 2018 were reviewed. These women were classified into 2 groups according to glycemic control during pregnancy: ≤ 1 occasion of either fasting glucose ≥ 95 mg/dL or 2-hour postprandial glucose ≥ 120 mg/dL was defined as optimal glycemic control or else was classified as suboptimal glycemic control. Rates of postpartum T2DM and prediabetes were compared between women with optimal (n = 505) and suboptimal (n = 201) glycemic control. Results The rates of postpartum T2DM and prediabetes were significantly higher in the suboptimal glycemic control group than in the optimal glycemic control group: 22.4% vs. 3.0%, P < 0.001 for T2DM and 45.3% vs. 23.5%, P < 0.001 for prediabetes. In a multivariate analysis, suboptimal glucose control during pregnancy was an independent risk factor for developing either postpartum T2DM or prediabetes. The adjusted odds ratios were 8.4 (95% confidence interval, 3.5–20.3) for T2DM and 3.9 (95% confidence interval, 2.5–6.1) for prediabetes. Conclusion Our findings suggest that blood glucose levels during GDM pregnancy have an impact on the risk of postpartum T2DM and prediabetes.


Gut ◽  
2018 ◽  
Vol 67 (9) ◽  
pp. 1614-1625 ◽  
Author(s):  
Jinfeng Wang ◽  
Jiayong Zheng ◽  
Wenyu Shi ◽  
Nan Du ◽  
Xiaomin Xu ◽  
...  

ObjectiveThe initial colonisation of the human microbiota and the impact of maternal health on neonatal microbiota at birth remain largely unknown. The aim of our study is to investigate the possible dysbiosis of maternal and neonatal microbiota associated with gestational diabetes mellitus (GDM) and to estimate the potential risks of the microbial shift to neonates.DesignPregnant women and neonates suffering from GDM were enrolled and 581 maternal (oral, intestinal and vaginal) and 248 neonatal (oral, pharyngeal, meconium and amniotic fluid) samples were collected. To avoid vaginal bacteria contaminations, the included neonates were predominantly delivered by C-section, with their samples collected within seconds of delivery.ResultsNumerous and diverse bacterial taxa were identified from the neonatal samples, and the samples from different neonatal body sites were grouped into distinct clusters. The microbiota of pregnant women and neonates was remarkably altered in GDM, with a strong correlation between certain discriminatory bacteria and the oral glucose tolerance test. Microbes varying by the same trend across the maternal and neonatal microbiota were observed, revealing the intergenerational concordance of microbial variation associated with GDM. Furthermore, lower evenness but more depletion of KEGG orthologues and higher abundance of some viruses (eg, herpesvirus and mastadenovirus) were observed in the meconium microbiota of neonates associated with GDM.ConclusionGDM can alter the microbiota of both pregnant women and neonates at birth, which sheds light on another form of inheritance and highlights the importance of understanding the formation of early-life microbiome.


2017 ◽  
Vol 11 (1) ◽  
pp. 25-28
Author(s):  
Farzana Akonjee Mishu ◽  
MA Muttalib

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 manufacturer’s 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


2016 ◽  
Vol 19 (2) ◽  
pp. 150-157 ◽  
Author(s):  
Tatiana V. Saprina ◽  
Ekaterina S. Timokhina ◽  
Olga K. Goncharevich ◽  
Svetlana V. Budeeva ◽  
Tatiana S. Prokhorenko ◽  
...  

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. 


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paola Quaresima ◽  
Federica Visconti ◽  
Fabiana Interlandi ◽  
Luigi Puccio ◽  
Patrizia Caroleo ◽  
...  

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.


2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei

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.


2018 ◽  
Vol 26 (1) ◽  
pp. 96-105 ◽  
Author(s):  
S. V. Yankina ◽  
N. V. Shatrova ◽  
S. V. Berstneva ◽  
D. N. Pavlov

Gestational diabetes mellitus (GDM) is a serious medical and social problem, because it greatly increases the frequency of adverse pregnancy outcomes for mother and fetus. The frequency of GDM in the general population of different countries varies from 1% to 14% and average 7%, in Russia this figure is estimated at 4.5%. Aim. To evaluate the prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years and examine its influence on the course and outcome of pregnancy. Materials and Methods. The analysis of the birth history data and exchange cards of 1690 pregnant women from 2015 to 2017 at Ryazan Regional clinical perinatal center. Results. GDM was diagnosed in 193 women (prevalence – 11.4%), with 62 pregnant women on the basis of the results of oral glucose tolerance test performed in the period of 24-30 weeks. It was established that the course of pregnancy and delivery in patients with GDM was characterized by a high percentage of complications (late gestosis – 18.1%, anemia – 11.3%, swelling – 11.9%, early toxicosis – 4.6%, poly-hydramnios – 12.4%, chronic pyelonephritis – 5.1% and threatened miscarriage – 3.6%). Pregnancy outcome study revealed that the majority – 60.6% of pregnancies ended in natural births. Preterm birth was noted in 15% of cases, of which 2 cases were of perinatal fetal death. The frequency of delivery by cesarean section – 39.4%. The frequency of childbirth large fetus was 21.8%, higher than in women with normal blood glucose levels. Conclusions. The prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years was 11.4%. Complications during pregnancy were observed in 153 women (79.2%) of with GDM. The most frequent complications were; late gestosis, pregnancy anemia, edema, early toxemia, polyhydramnios, chronic pyelonephritis, and threatened miscarriage. In pregnant women with GDM, adverse outcomes of pregnancy were more common than in women with normoglycemia. Significant differences were obtained in the frequency of premature birth, macrosomia of the fetus and asphyxia during childbirth.


2021 ◽  
Vol 29 (1) ◽  
pp. 33-38
Author(s):  
Melike Nur Akın ◽  
Burcu Kasap ◽  
Fatih Akın ◽  
Burak Sezgin ◽  
İbrahim Altun ◽  
...  

Objective We aimed to assess the relationship between gestational diabetes mellitus and coronary artery disease by measuring epicardial fat tissue thickness and aortic stiffness in pregnant women diagnosed with gestational diabetes mellitus. Methods 28 pregnant women diagnosed with gestational diabetes mellitus and 25 pregnant women without gestational diabetes mellitus were included in the research. Body mass index, laboratory values, blood pressure measurements and obstetric history findings of the study population were recorded. All participants of the study population were evaluated with transthoracic echocardiography between 24 and 28 weeks of gestational period. The measurement of epicardial fat tissue thickness was taken and aortic stiffness index was also calculated. Results The age, gravidity, parity and obstetric history of the two groups were similar. Epicardial fat tissue thickness was found significantly higher in gestational diabetes mellitus group than control group (0.416 cm and 0.336 cm, respectively; p<0.001). However, no significant difference was found in aortic stiffness measurements of the two groups (p=0.079). Conclusion According to the results of our study, epicardial fat tissue thickness was found to be statistically significantly higher in pregnant women with gestational diabetes mellitus compared to the control group. The fact that no difference was detected in other cardiovascular parameters suggests that measurement of epicardial fat tissue thickness in gestational period may be a beneficial adjunctive tool in early detection of gestational diabetes mellitus.


Author(s):  
Ankita Kumari ◽  
Shaila Mitra ◽  
Harish C Tiwari ◽  
Reena Srivastav

Background: Hypovitaminosis D has been associated with a number of adverse pregnancy outcomes, and has been recognised as a public health concern. The objective of this study was to determine the impact of Vitamin D deficiency on maternal complications like gestational diabetes mellitus (GDM) and preeclampsia (PE) among pregnant women.Methods: This was a case control study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur, Uttar Pradesh, India. Two maternal blood samples, one at <20 weeks and other at term along with cord blood at delivery were taken. Patients were classified into preeclampsia (n=60), gestational diabetes mellitus (n=35) and control group (n=180) after abstracting past medical records at delivery. Vitamin D was estimated by 25- Hydroxyvitamin D125 RIA kit and categorized according to ACOG criteria. Statistical analysis was done by using chi square test, binary logistic regression and Pearson’s correlation coefficient to compare between two variables. P<0.05 was considered statistically significant.Results: Out of 275 women included in the study, 78% of women were Vitamin D deficient. Mean serum vitamin D was significantly lower among preeclamptic women 11.53±6.22 ng/ml and GDM women 12.62±6.69 ng/ml as compared to controls 24.25±14.44 ng/ml (median=18.2 ng/ml) (P<0.05). Vitamin D deficiency was significantly higher in pregnant women GDM (94.28% vs 68.3%) and preeclampsia (96.67% vs 68.3%) when compared to uncomplicated group.Conclusions: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is significantly associated with elevated risk for GDM and preeclampsia.


Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.

Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.


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