DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174413

Correlation of serum biomarkers in prediction of gestational diabetes mellitus

Maya Menon, M. Alaganandha, Jayanthi Mohan

Abstract


Background: Adiponectin and Leptin are adipokines produced by adipocytes. TNF-alpha and IL-6 are inflammatory cytokines which increases insulin resistance. Decreased adiponectin, increased leptin, TNF-alpha and IL-6 is associated with risk of Gestational Diabetes Mellitus, characterised by glucose intolerance that begins or first recognised in pregnancy leading to maternal and foetal complications. India has a high prevalence of GDM upto 16.55% by (2hr plasma glucose of more than 140mg/dl). We aimed to evaluate whether ‘First trimester serum biomarkers predict gestational diabetes mellitus’. The objective of the study was to study the serum biomarkers levels in early pregnancy and predict the risk of developing gestational diabetes mellitus. To study the correlation of serum biomarkers levels in gestational diabetes mellitus.

Methods: The study was conducted between October 2014 to March 2016 in healthy pregnant women aged 20-35 yrs attending the antenatal OPD in ESIC Hospital. Study design: Prospective observational study with three study groups 1. NGT, 2. GDM1, 3. GDM2 with two-time points one at first trimester and other second trimester. Sample size: 125 pregnant women. Work plan: Demographics, baseline characteristics and other clinical risk factors of pregnant women in 1st trimester who consented for the study, meeting the inclusion criteria are noted. 75 gm OGCT (oral glucose challenge test) done at two-time points first and second trimester in the study groups will be analysed using the DIPSI criteria with a cut-off value ≥140mg/dl and divided into 3 groups. Serum biomarkers were measured by DRG ELISA method at one-time point in first trimester in all the 3 groups.

Results: The serum levels of adiponectin are comparatively reduced in first trimester GDM1 group. As the difference was not significant with p-value of 0.33 there was no correlation between adiponectin and GDM in our study. Serum leptin is increased in second trimester GDM group but the difference is insignificant with a p value of 0.11 showing no correlation.

Conclusions: Among the cytokines IL-6 also shows an increasing tendency in both GDM1 (5.9±0.57) and GDM2 (6.04±1.04) groups compared to the NGT (5.82±0.38) group. Serum TNFα is increased in GDM1 (17.29±17.14) and NGT (17.03±24.03) compared to GDM2 (13.54±17.29) group.

 


Keywords


Gestational Diabetes Mellitus, Serum biomarkers

Full Text:

PDF

References


Wauters M, Considine RV, and VanGaal LF. Humanleptin from an adipocyte hormone to an endocrine mediator. European J Endocrinol. 2000;143(3):293-311.

Abell SK, De Courten B, Boyle JA, Teede HJ. Inflammatory and Other Biomarkers: Role in Pathophysiology and Prediction of Gestational Diabetes Mellitus. Int J Mol Sci. 2015;16:13442-73.

Freinkel N, Metzger BE, Phelps RL, Dooley SL, Ogata ES, Radvany RM, et al. Gestational diabetes mellitus. Heterogeneity of maternal age, weight, insulin secretion, HLA antigens, and islet cell antibodies and the impact of maternal metabolism on pancreatic B-cell and somatic development in the offspring. Diabetes. 1985;34(2):1-7.

Khan R, Ali K, Khan Z. Socio-demographic risk factors of Gestational Diabetes Mellitus. Pak J Med Sci. 2013;29(3):843-6.

Seshiah V, Balaji V, Balaji MS. Prevalence of gestational diabetes mellitus in south india (Tamilnadu)-a community based study. J Assoc Physicians India. 2008;56:329-33.

Khan UI, Wang D, Sowers MR, Mancuso P, Eversonrose SA, Scherer PE, et al. Race-ethnic differences in adipokine levels: The Study of Women's Health Across the Nation. Metabolism. 2012;61:1261-69.

Gavrila A, Chan JL, Yiannakouris N. Serum adiponectin levels are inversely associated with overall and central fat distribution but are not directly regulated by acute fasting or leptin administration in humans: cross-sectional and interventional studies. J Clin Endocrinol Metab. 2003;88:4823-31.

Lappas M, Yee K, Permezel M, Rice GE. Release and regulation of leptin, resistin and adiponectin from human placenta, fetal membranes, and maternal adipose tissue and skeletal muscle from normal and gestational diabetes mellitus-complicated pregnancies. J Endocrinol. 2005;186:457-65.

Meller M, Qiu C, Kuske BT, Abetew DF, Muy-Rivera M, Williams MA. Adipocytokine expression in placentas from pre-eclamptic and chronic hypertensive patients. Gynecol Endocrinol. 2006;22: 267-73.

Georgiou HM, Lappas M, Georgiou GM. Screening for biomarkers predictive of gestational diabetes mellitus. Acta Diabetol. 2008;45:157-65.

Lain KY, Daftary AR, Ness RB, Roberts JM. First trimester adipocytokine concentrations and risk of developing gestational diabetes later in pregnancy. Clin Endocrinol (Oxf). 2008;69:407-11.

Elham N, Nasrin F, Safoura R. Is there any relation between Adiponectin Levels in the first trimester of pregnancy and Gestational Diabetes Scient Open Access J Womens Health Gynaecol. 2016;2(4)32.

Saini V, Kataria M, Yadav A, Jain A. Role of leptin and adiponectin in gestational diabetes mellitus. Internet J Medic Update. 2015;10(1):11-4.

Sedigheh S, Mahdieh M, Soodabeh R. Maternal serum leptin concentration in gestational diabetes. Taiwanese J Obstetr Gynaecol. 2011;50:149-53.

Skvarca A, Tomazic M, Blagus R, Krhin B, Janez A. Adiponectin/leptin ratio and insulin resistance in pregnanct. J Internat Medi Res. 2013;41(1):123-8.

Paradisi G, Ianniello F, Tomei C, Bracaglia M. Longitudinal changes of adiponectin, carbohydrate and lipid metabolism in pregnant women at high risk for gestational diabetes Gynecol Endocrinol. 2010; 26(7):539-45.

Kylie AM, David N, Alicia J. Do adiponectin, TNFα, leptin and CRP relate to insulin resistance in pregnancy? Studies in women with and without gestational diabetes, during and after pregnancy. Diabetes Metab Res Rev. 2006;22:131-8.

Saucedo R, Zarate A, Basurto L, Hernandez M, Puello E, Galvan R, et al. Relationship between circulating adipokines and insulin resistance during pregnancy and postpartum in women with gestational diabetes. Arch. Med. Res. 2011;42:318-23.

Mazaki-Tovi1 S, Kanety H, Pariente C. Maternal serum adiponectin levels during human pregnancy. J Perinatol. 2007;27:77-81.

Kautzky-Willer A, Pacini G, Tura A, Bieglmayer C. Increased plasma leptin in gestational diabetes. Diabetologia. 2001;44(2):164-72.