Association of maternal serum total homocysteine level with gestational diabetes mellitus

Authors

  • Chowdhury Afsana Haider Directorate General of Health Services (DGHS), Dhaka, Bangladesh
  • M. Mushfiqul Islam Department of Critical Care Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • M. Muhtarema Fatema Directorate General of Health Services (DGHS), Dhaka, Bangladesh
  • M. Karimatun Nesa Upazila Health Complex, Nachole, Chapainawabganj, Bangladesh
  • Farzana Farhin Khan Department of Obstetrics and Gynecology, 100-bedded District hospital, Narsingdi, Bangladesh
  • Halima Jahan Ripa 250 Bedded General Hospital, Jamalpur, Bangladesh
  • Naorin Ahmed Upazila Health Complex, Nachole, Chapainawabganj, Bangladesh
  • Nusrat Jahan Eva Department of Obstetrics and Gynecology, Government Unani and Ayurvedic Medical College, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20254288

Keywords:

Homocysteine, Gestational diabetes, Pregnancy

Abstract

Background: Gestational diabetes mellitus (GDM) is diabetes first diagnosed during pregnancy, affecting a significant proportion of pregnancies worldwide. This study was conducted to determine the association between maternal serum total homocysteine levels and GDM. The aim of the study was to evaluate the association between maternal serum total homocysteine levels and the occurrence of gestational diabetes mellitus.

Methods: This case-control study was conducted in the Department of Obstetrics and Gynecology, Institute of Child and Mother Health (ICMH), Matuail, Dhaka, Bangladesh, from October 2023 to March 2025, including 36 pregnant women with GDM and 36 matched controls. Demographic, obstetric, and biochemical data, including serum total homocysteine (Hcy) levels measured by ELISA, were collected, and associations with blood glucose were analyzed using SPSS 27.0; GDM was diagnosed per WHO (2013) criteria and elevated Hcy defined as ≥6.38 µmol/l.

Results: Among 72 pregnant women, mean serum total homocysteine was higher in GDM cases than controls (9±3.5 vs. 6.7±3.7 µmol/l, p=0.008). Women with homocysteine ≥6.38 µmol/L had 4.55 times higher odds of GDM (95% CI: 1.69-12.25, p=0.003). Homocysteine levels correlated positively with fasting blood sugar (r=0.543, p<0.001) and 2-hour post-75g glucose (r=0.388, p=0.001).

Conclusions: This study establishes that elevated maternal serum total homocysteine levels are associated with gestational diabetes mellitus and may serve as a potential biomarker for GDM risk.

 

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References

American Diabetes Association Professional Practice Committee, American Diabetes Association Professional Practice Committee: 15. Management of diabetes in pregnancy: Standards of Medical Care in Diabetes-2022. Diabet Care. 2022;45(Supplement_1):S232-43. DOI: https://doi.org/10.2337/dc22-S015

Gong T, Wang J, Yang M, Shao Y, Liu J, Wu Q, et al. Serum homocysteine level and gestational diabetes mellitus: A meta‐analysis. J Diabet Investigat. 2016;7(4):622-8. DOI: https://doi.org/10.1111/jdi.12460

Jamieson EL, Dimeski G, Flatman R, Hickman PE, Jones GR, Marley JV, et al. Oral glucose tolerance test to diagnose gestational diabetes mellitus: impact of variations in specimen handling. Clin Biochem. 2023;115:33-48. DOI: https://doi.org/10.1016/j.clinbiochem.2022.10.002

Kumari A, Singh C. A review on gestational diabetes mellitus during pregnancy. J Drug Deliver Therapeut. 2019;9(3-S):1123-5. DOI: https://doi.org/10.22270/jddt.v9i3-s.2997

Jesmin S, Akter S, Akashi H, Al-Mamun A, Rahman MA, Islam MM, et al. Screening for gestational diabetes mellitus and its prevalence in Bangladesh. Diabet Res Clin Pract. 2014;103(1):57-62. DOI: https://doi.org/10.1016/j.diabres.2013.11.024

Sililas P, Huang L, Thonusin C, Luewan S, Chattipakorn N, Chattipakorn S, et al. Association between gut microbiota and development of gestational diabetes mellitus. Microorgan. 2021;9(8):1686. DOI: https://doi.org/10.3390/microorganisms9081686

Chiefari E, Arcidiacono B, Foti D, Brunetti A. Gestational diabetes mellitus: an updated overview’. J Endocrinol Investigat. 2017;40(9):899-909. DOI: https://doi.org/10.1007/s40618-016-0607-5

Lindsay KL, Hellmuth C, Uhl O, Buss C, Wadhwa PD, Koletzko B, et al. Longitudinal metabolomic profiling of amino acids and lipids across healthy pregnancy. PloS one. 2015;10(12):e0145794. DOI: https://doi.org/10.1371/journal.pone.0145794

Bonet B, Viana M, Sánchez-Vera I. Intermediary metabolism in pregnancies complicated by gestational diabetes. In: Textbook of Diabetes and Pregnancy. 2nd ed. CRC Press;2008:55-60. DOI: https://doi.org/10.3109/9781439802007.006

Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci. 2018;19(11):3342. DOI: https://doi.org/10.3390/ijms19113342

Zielińska-Maciulewska A, Krętowski A, Szelachowska M. Insulin resistance and adaptation of pancreatic beta cells during pregnancy. Clin Diabetol. 2018;7(5):222-9. DOI: https://doi.org/10.5603/DK.2018.0022

Gaiday AN, Tussupkaliyev AB, Bermagambetova SK, Zhumagulova SS, Sarsembayeva LK, Dossimbetova MB, et al. Effect of homocysteine on pregnancy: a systematic review. Chem-biolog Interact. 2018;293:70-6. DOI: https://doi.org/10.1016/j.cbi.2018.07.021

Alatab S, Fakhrzadeh H, Sharifi F, Mirarefin M, Badamchizadeh Z, Ghaderpanahi M, et al. Correlation of serum homocysteine and previous history of gestational diabetes mellitus. J Diabet Metabol Dis. 2013;12(1):34. DOI: https://doi.org/10.1186/2251-6581-12-34

Huang T, Ren J, Huang J, Li D. Association of homocysteine with type 2 diabetes: a meta-analysis implementing Mendelian randomization approach. BMC Genom. 2013;14(1):867. DOI: https://doi.org/10.1186/1471-2164-14-867

Mazza A, Bossone E, Mazza F, Distante A. Reduced serum homocysteine levels in type 2 diabetes. Nutrit Metabol Cardiovas Dis. 2005;15(2):118-24. DOI: https://doi.org/10.1016/j.numecd.2004.03.001

Persson M, Winkvist A, Mogren I. From population control to health promotion: a qualitative study of midwives’ perceptions of their work tasks and professional development in Vietnam. BMC Pregnan Childb. 2015;15.

MacNeill S, Dodds L, Hamilton DC, Armson BA, VandenHof M. Rates and risk factors for recurrence of gestational diabetes. Diabet Care. 2001;24(4):659-62. DOI: https://doi.org/10.2337/diacare.24.4.659

Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, et al. Prevalence of gestational diabetes mellitus and its risk factors in Chinese pregnant women: a prospective population-based study in Tianjin, China. PloS one. 2015;10(3):e0121029. DOI: https://doi.org/10.1371/journal.pone.0121029

Tanzin ST, Rahman MA, Begum K, Choudhury FH, Bushra RT, Akter H. Association of elevated serum homocysteine level in women with gestational diabetes mellitus. Scholars Int J Obstetr Gynecol. 2023;6(5):193-200. DOI: https://doi.org/10.36348/sijog.2023.v06i05.006

Amiri FN, Faramarzi M, Bakhtiari A, Omidvar S. Risk factors for gestational diabetes mellitus: a case-control study. Am J Lifestyle Med. 2018;15(2):184-90. DOI: https://doi.org/10.1177/1559827618791980

Guven MA, Kilinc M, Batukan C, Ekerbicer HC, Aksu T. Elevated second trimester serum homocysteine levels in women with gestational diabetes mellitus. Arch Gynecol Obstetr. 2006;274(6):333-7. DOI: https://doi.org/10.1007/s00404-006-0191-6

Deng M, Zhou J, Tang Z, Xiang J, Yi J, Peng Y, et al. The correlation between plasma total homocysteine level and gestational diabetes mellitus in a Chinese Han population. Sci Rep. 2020;10(1):18679. DOI: https://doi.org/10.1038/s41598-020-75797-w

Nessa M, Das TR, Jahan E, Khan MM. Association of serum homocysteine with Gestational Diabetes Mellitus (GDM): a case-control study. Bangabandhu Sheikh Mujib Med Coll J. 2024;3(1):32-7. DOI: https://doi.org/10.3329/bsmmcj.v3i1.71966

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Published

2025-12-29

How to Cite

Haider, C. A., Islam, M. M., Fatema, M. M., Nesa, M. K., Khan, F. F., Ripa, H. J., Ahmed, N., & Eva, N. J. (2025). Association of maternal serum total homocysteine level with gestational diabetes mellitus. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 15(1), 243–248. https://doi.org/10.18203/2320-1770.ijrcog20254288

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Original Research Articles