Fatty Liver Index and Serum Copeptin as Early Predictors of Gestational Diabetes Mellitus in Non-diabetic Pregnant Women

Abstract

The body responses to metabolic demands of pregnancy still a challenging concern for physicians [1] and became a stressful target with the global increasing prevalence of obesity [2]. During pregnancy glucose metabolism is governed by equilibrium between lactogenic hormones stimulating insulin production and counter-regulatory hormones inducing insulin resistance (IR) [3]. Multiple peptides play a major role in pathogenesis of metabolic disorders [4] and substances of hormonal character secreted by adipose tissue (Adipokines) are of great importance for carbohydrate metabolism [5]. Multiple studies documented disturbed adipokines levels early in pregnancy among women who later develop GDM than women completed their pregnancy free of GDM [6]. Copeptin (CP), a 39-aminoacid glycopeptide, is the COOH-terminal portion of the precursor pre-pro-vasopressin [7]. Activation of the Arginine vasopressin (AVP) system stimulates CP secretion into the circulation from the posterior pituitary gland in equimolar amounts with AVP [8]. Therefore, CP directly reflects AVP concentration and can be used as a surrogate biomarker of AVP secretion [9]. Fatty liver disease (FLD) is one of the most frequent liver diseases and includes nonalcoholic and alcoholic FLD, each of which is increasing in prevalence [10]. Obesity and its