Association between the ferritin level and risk of gestational diabetes mellitus: A meta‐analysis of observational studies

Abstract

Aims/Introduction: The relationship between ferritin and the risk of gestational diabetes mellitus (GDM) has not been established. Thus, we carried out a meta-analysis based on the current literature. Materials and Methods:We searched relevant databases on Embase, PubMed, Cochrane Library and Web of Science before 10 May 2019 to determine the relationship between ferritin and the risk of GDM. The relative risks and 95% confidence intervals of GDM risk were summarized using a random effects model. Studies using categories of ferritin as exposure were combined by dose-response analysis. We carried out both linear and non-linear trends. We also carried out subgroup analysis, whether or not the studies adjusted for potential confounders, and meta-regression analysis to explore the source of heterogeneity. Sensitivity analysis was carried out to explore the robustness of the metaanalysis results. Results: A total of 10 studies involving 4,690 participants were identified. The summary relative risk comparing persons with the highest concentration categories of ferritin with the lowest concentration categories of ferritin was 1.87 (95% confidence interval 1.50-2.34; I 2 = 20.1%). Linear dose-response showed that an increase in ferritin of 10 lg/L increased the risk of GDM by 8% (1.08, 95% confidence interval 1.05-1.13, I 2 = 55.1%; n = 4). A nonlinear dose-response relationship also showed a consistently increasing risk of GDM with increased ferritin. No evidence of publication bias was detected. Conclusions: The findings from this meta-analysis suggest that increased ferritin levels are associated with an increased risk of GDM; however, we require further prospective cohort studies to confirm the results, especially the dose-response relationship between ferritin and GDM.

Iron Metabolism in Pancreatic Beta-Cell Function and Dysfunction

“…Even a mild degree of iron excess, below levels typical of haemochromatosis or other iron-storage disorders, has been associated with an increased risk of gestational diabetes [ 145 , 146 , 147 , 148 ] and to an increased risk of developing non-alcoholic fatty liver disease (NAFLD) in the presence of metabolic syndrome [ 149 ].…”

Adiponectin ameliorates placental injury in gestational diabetes mice by correcting fatty acid oxidation/peroxide imbalance-induced ferroptosis via restoration of CPT-1 activity

“…The development of diabetes also promotes iron deposition in the body, leading to an increase in ferritin [28]. The increase of ferritin was associated with abnormal glucose metabolism, suggesting that excessive iron deposition could promote the pathogenesis of GDM [29,30]. In our experiment, it was found that oxidative stress level, iron deposition level, lipid peroxide reduction ability, and abnormal expression of ferroptosis-related proteins in placental tissues were significantly increased after HL and HG induction.…”

Association of Iron Metabolism Abnormalities as Etiopathogenetic Factor in Alteration of Beta Cell Function and Impairment in Generation of Diabetes Mellitus: A Systematic Review

“…Minimal iron overload also that is under the amounts that is classical of haemochromatosis or other iron storage abnormalities, has been correlated with the escalation of risk of generation of Gestational Diabetes mellitus [126,127], besides that of non-alcoholic fatty liver disease INAFLD) in the existence of Metabolic Syndrome [128].…”