Relationship of maternal serum zinc level with gestational diabetes mellitus

Tabassum Tamanna; Sharmeen Mahmood; Begum Nasrin; Tripti Rani Das

doi:10.18203/2320-1770.ijrcog20234077

Authors

Tabassum Tamanna Department of Obstetrics and Gynecology, Kushtia Medical College Hospital, Kushtia, Bangladesh
Sharmeen Mahmood Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Begum Nasrin Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Tripti Rani Das Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20234077

Keywords:

Gestational diabetes mellitus, Pregnancy, Zinc

Abstract

Background: Gestational diabetes mellitus (GDM) is a prevalent pregnancy disease in Bangladesh that poses risks to the health of both mother and fetus. Glycosuria-related nutritional deficiencies are often associated with GDM. Zinc, an essential micronutrient, plays a central role in insulin-mediated glucose metabolism and storage. Because of its importance in insulin-related processes, zinc deficiency is potentially relevant to pregnancy-related carbohydrate intolerance. The aim of this study was to evaluate the relationship of maternal zinc deficiency with gestational diabetes mellitus.

Methods: This case-control study, conducted from October 2020 to September 2022, involved 160 pregnant women aged 18-35 from the Department of Obstetrics and Gynecology, BSMMU, Dhaka. Of these, 80 women diagnosed with GDM (24-40 weeks gestation) and 80 matched healthy controls were included in our study.

Results: The mean (SD) zinc level was much lower in the cases than in the controls (59.60±19.37 µg/dl and 91.84±38.19 µg/dl, respectively; p-value = <0.001). There was a significant negative correlation of serum zinc levels with both FBG (r=-0.406, p<0.001) and 2HABG (r=-0.381, p<0.001). The likelihood of developing gestational diabetes was approximately 4.2 times higher in mothers with low serum zinc (<68 g/dL) than in mothers with zinc levels of 68 g/dL (p<0.001; OR=4.214; 95%- CI=2.158-8.231).

Conclusions: Low maternal serum zinc levels have been found to be associated with gestational diabetes mellitus. Therefore, the serum zinc level can be used as a predictor to determine the risk of developing gestational diabetes mellitus.

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References

American Diabetes Association. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Supplement 1):S15-S33.

Ornoy A, Becker M, Weinstein-Fudim L, Ergaz Z. Diabetes during pregnancy: A maternal disease complicating the course of pregnancy with long-term deleterious effects on the offspring. a clinical review. Int J Mole Sci. 2021;22(6):1-36.

Sililas P, Huang L, Thonusin C, Luewan S, Chattipakorn N, Chattipakorn S, et al. Association between gut microbiota and development of gestational diabetes mellitus. Microorg. 2021;9(8):1-10.

WHO. Global report on diabetes: executive summary, 2016;1-4. Available at: https://apps.who.int/iris/bitstream/handle/10665/204874/WHO_NMH_NVI_16.3_eng.pdf?sequence=1&isAllowed=y. Accessed 19 September 2022.

Davidson KW, Barry MJ, Mangione CM, Cabana M, Caughey AB, Davis EM, et al. Screening for gestational diabetes: US preventive services task force recommendation statement. JAMA. 2021;326(6):531-8.

Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregn Childb. 2018;18(1):1-20.

Anjana R, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study. Diabetol. 2011;54(12):3022-3027.

Mohiuddin A. Diabetes fact: Bangladesh perspective. Int J Diab Res. 2019;2(1):14-20.

Halim A, Abdullah ASM, Rahman F, Biswas A. Exploring the perceptions, practices and challenges of gestational diabetes detection and management among health care providers in a district of Bangladesh. F1000 Res. 2020;9(189):1-13.

Mishra S, Rao CR, Bhadoria AS, Mohanty S, Kishore S, Chaudhary AS. Life-cycle approach for prevention of gestational diabetes mellitus. Clin Epidemiol Glob Heal. 2019;7(3):418-23.

Draznin B, Aroda VR, Bakris G, Benson G, Brown FM, Freeman R, et al. Classification and diagnosis of diabetes: standards of medical care in diabetes-2022. Diabet Care. 2022;45(Suppl 1):S17-S38.

Plows J, Stanley J, Baker P, Reynolds C, Vickers M. The pathophysiology of gestational diabetes mellitus. Int J Mole Sci. 2018;19(11):1-21.

Li W, Zhang S, Liu H, Wang L, Zhang C, Leng J, et al. Different associations of diabetes with β-cell dysfunction and insulin resistance among obese and nonobese Chinese women with prior gestational diabetes mellitus. Diab Care. 2014;37(9):2533-9.

Mishu FA, Muttalib M, Sultana B. Serum zinc and copper levels in gestational diabetes mellitus in a tertiary care hospital of Bangladesh. BIRDEM Medi J. 2018;8(1):52-5.

Donangelo CM, Vargas Zapata CL, Woodhouse LR, Shames DM, Mukherjea R, King JC. Zinc absorption and kinetics during pregnancy and lactation in Brazilian women. Ame J Clin Nutrit. 2005;82(1):118-24.

Lima VBS, Sampaio FA, Bezerra DLC, Moita Neto JM, Marreiro DN. Parameters of glycemic control and their relationship with zinc concentrations in blood and with superoxide dismutase enzyme activity in type 2 diabetes patients. Arq Brasil Endocrinol Metabol. 2011;55(9):701-7.

Wiernsperger N, Rapin J. Trace elements in glucometabolic disorders: an update. Diabetol Metabol Synd. 2010;2(1):1-9.

Hamza RT, Hamed AI, Sallam MT. Effect of zinc supplementation on growth hormone insulin growth factor axis in short Egyptian children with zinc deficiency. Ita J Pediatr. 2012;38(1):1-7.

Petersen AB, Smidt K, Magnusson NE, Moore F, Egefjord L, Rungby J. siRNA‐mediated knock‐down of ZnT3 and ZnT8 affects production and secretion of insulin and apoptosis in INS‐1E cells. Apmis. 2011;119(2):93-102.

Behboudi-Gandevani S, Safary K, Moghaddam-Banaem L, Lamyian M, Goshtasbi A, Alian-Moghaddam N. The relationship between maternal serum iron and zinc levels and their nutritional intakes in early pregnancy with gestational diabetes. Biol Tra Elem Res. 2013;154(1):7-13.

Hoseini H, Sarabandi A, Rezaei MR, Etemadi S, Sarani A, Rezaei F. Evaluation of serum zinc levels in pregnant women with gestational diabetes compared with non-diabetic pregnant women. J Chem Heal Risk. 2021;11(Special Issue: Bioactive Compounds: Their Role in the Prevention and Treatment of Diseases):27-31.

Mishu F, Boral N, Ferdous N, Nahar S, Sultana G, Yesmin M, et al. Estimation of serum zinc, copper and magnesium levels in Bangladeshi women with gestational diabetes mellitus attending in a tertiary care hospital. MMJ. 2019;28(1):157-62.

Zhu G, Zheng T, Xia C, Qi L, Papandonatos GD, Ming Y, et al. Plasma levels of trace element status in early pregnancy and the risk of gestational diabetes mellitus: A nested case-control study. J Tra Elem Medi Biol. 2021;68:1-8.

Johns EC, Denison FC, Norman JE, Reynolds RM. Gestational diabetes mellitus: mechanisms, treatment, and complications. Tr Endocrin Metabol. 2018;29(11):743-54.

Monir N, Zeba Z, Rahman A. Comparison of knowledge of women with gestational diabetes mellitus and healthy pregnant women attending at hospital in Bangladesh. J Sci Found. 2018;16(1):20-6.

Ejezie F, Nwagha U. Zinc concentration during pregnancy and lactation in Enugu, South-East Nigeria. Ann Med Heal Sci Res. 2011;1(1):69-76.

Khan R, Ali K, Khan Z. Socio-demographic risk factors of gestational diabetes mellitus. Pak J Medi Sci. 2013;29(3):1-6.

Bouthoorn SH, Silva LM, Murray SE, Steegers EA, Jaddoe VW, Moll H, et al. Low-educated women have an increased risk of gestational diabetes mellitus: the Generation R Study. Acta Diabetol. 2015;52(3):445-52.

Akter S, Jesmin S, Rahman MM, Islam MM, Khatun MT, Yamaguchi N, et al. Higher gravidity and parity are associated with increased prevalence of metabolic syndrome among rural Bangladeshi women. PloS one. 2013;8(8):1-8.

Torloni M, Betran A, Horta B, Nakamura M, Atallah A, Moron A, et al. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta‐analysis. Obes Revi. 2009;10(2):194-203.

Yen I-W, Lee C-N, Lin M-W, Fan K-C, Wei J-N, Chen K-Y, et al. Overweight and obesity are associated with clustering of metabolic risk factors in early pregnancy and the risk of GDM. PLoS One. 2019;14(12):1-9.

Roshanravan N, Alamdari NM, Ghavami A, Mousavi R, Alipour S, Ebrahimi-Mamaghani M. Serum levels of copper, zinc and magnesium in pregnant women with Impaired Glucose Tolerance test: a case-control study. Prog Nutr. 2017;20:1-5.

Bo S, Lezo A, Menato G, Gallo M-L, Bardelli C, Signorile A, et al. Gestational hyperglycemia, zinc, selenium, and antioxidant vitamins. Nutrition. 2005;21(2):186-91.

Wang Y, Tan M, Huang Z, Sheng L, Ge Y, Zhang H, et al. Elemental contents in serum of pregnant women with gestational diabetes mellitus. Biol Tra Elem Res. 2002;88(2):113-8.

Al-Saleh E, Nandakumaran M, Al-Rashdan I, Al-Harmi J, Al-Shammari M. Maternal-foetal status of copper, iron, molybdenum, selenium and zinc in obese gestational diabetic pregnancies. Acta Diabetol. 2007;44(3):106-13.

Afridi HI, Kazi TG, Kazi N, Baig JA, Jamali MK, Arain MB, et al. Status of essential trace metals in biological samples of diabetic mother and their neonates. Arch Gynecol Obstet. 2009;280(3):415-23.

Karamali M, Heidarzadeh Z, Seifati SM, Samimi M, Tabassi Z, Hajijafari M, et al. Zinc supplementation and the effects on metabolic status in gestational diabetes: a randomized, double-blind, placebo-controlled trial. J Diabet Comp. 2015;29(8):1314-9.

Luo J, Wu W, Zhang P, Chen X, Feng Y, Ma N, et al. Zinc Levels and Birth Weight in Pregnant Women with gestational diabetes mellitus: a matched cohort study in China. J clin endocrinol metabol. 2020;105(7):1-23.