Cytokine Levels in Gestational Diabetes Mellitus: a Systematic Review of the Literature

Abstract

CitationGomes CP, Torloni MR, Gueuvoghlanian-Silva BY, Alexandre SM, Mattar R, Daher S. Cytokine levels in gestational diabetes mellitus: a systematic review of the literature. Am J Reprod Immunol 2013; 69: 545-557 doi:10.1111/aji.12088 Problem Gestational diabetes mellitus (GDM) is an inflammatory condition that involves unbalanced cytokine production. We carried out a systematic review on the relationship between GDM and maternal circulating levels of cytokines in the 2nd/3rd trimesters. Method of StudyThree electronic databases (MEDLINE, EMBASE and LILACS), were searched. Duplicate study selection, extraction and quality assessment was performed. ResultsTwenty-two studies with 1982 participants reporting levels of 9 cytokines (IL-1B, IL-2, IL-6, IL-10, IL-13, IL-18, IFN-G, TGF-B and TNF-A) were included. Most studies differed considerably in selection criteria, sampling and assay methods and in reporting their results. Consequently, only two studies could be pooled: TNF-A concentration was slightly higher in GDM than in control patients, although not significant (WMD = 0.45, 95% CI À0.34-1.23). ConclusionsNew studies with well-defined, more homogeneous methodological parameters are needed to detect whether there are significant differences in circulating levels of cytokines in patients with GDM.

Relation between fetal anthropometric parameters and cord blood adiponectin and high-sensitivity C-reactive protein in gestational diabetes mellitus

“…glucose tolerance that develops or is first diagnosed during pregnancy (1)(2)(3). Recent studies have shown a 20-fold increase in the prevalence of GDM.…”

“…Recent studies have shown a 20-fold increase in the prevalence of GDM. A further 4-fold increase in prevalence is anticipated (3,4) after adoption of the new diagnostic criteria suggested by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) (1,5). The presence of GDM means that many infants are exposed to hyperglycemic conditions in utero which can cause neonatal adiposity and metabolic disorders later in life.…”

“…Recent studies have shown that the inflammatory system may play a role in the development and pathogenesis of GDM (1). Insulin resistance and inflammation are major features of maternal metabolic state in women with GDM.…”

“…This upregulation increases or unbalances production of inflammatory cytokines and energy metabolism regulatory cytokines such as adipokines (2,6,7), which increases adiposity at birth (8,9) and predisposes the newborn to become overweight and develop metabolic diseases such as impaired glucose tolerance, metabolic syndrome, and cardiovascular disease (2,(6)(7)(8). Previous studies have focused on the pathophysiologic pathways and cytokine levels in GDM and their possible effect on offspring comorbidities later in life (1,6,7,10).…”

Porównanie ekspresji IL6 w leukocytach pacjentek z cukrzycą ciążową (GDM) diagnozowanych zgodnie z kryteriami Polskiego Towarzystwa Diabetologicznego z 2011 i 2014 roku

“…Despite the fact that the relationship of IL-6 with GDM has been increasingly investigated in recent years, conflicting findings exist regarding its levels in patients with GDM vs. healthy pregnant controls. In this respect, a recently performed metaanalysis of IL-6 levels in patients with and without GDM in the 2nd/3rd trimesters has revealed that among seven analyzed studies, four have shown comparable concentrations of this cytokine in patients with and without GDM, and three have reported its elevated levels in patients with GDM compared with healthy controls [13].…”