Implications of inflammation and insulin resistance in obese pregnant women with gestational diabetes: A case study

Abstract

Background: Obesity is one of the leading pregnancy risks for both the mother and the neonate. The prevalence of gestational diabetes mellitus has been increasing, especially with the increase in obesity in reproductive-aged women. A high body mass index, a sedentary lifestyle, a previous macrosomic infant, polycystic ovary syndrome and hypothyroidism are the main risk factors for gestational diabetes mellitus. Early gestational diabetes mellitus detection in high-risk individuals is a useful method for preventing further complications and/or preventing this disease by improving the patient’s lifestyle. Case presentation: A morbidly obese woman with a high body mass index (>36) at 24 weeks gestational age presented with several gestational diabetes mellitus risk factors. Her glucose tolerance test verified gestational diabetes mellitus, and, incidentally, her C-reactive protein level was elevated without obvious reason. Her plasma levels of inflammatory cytokines had also been assessed and were exaggerated. After lifestyle intervention, including weight management, the patient’s inflammatory mediators, including her C-reactive protein level, dropped. Therefore, this study aimed to identify the relationship between the patient’s inflammation and obesity. Conclusion: Antenatal C-reactive protein screening could be used throughout pregnancy to predict inflammation from high-risk pregnant women. This case scenario describes the interrelationships between inflammation, insulin resistance and adipokines, as well as the contributions of hypothyroidism and polycystic ovary syndrome. Further research should emphasise the relationships between inflammation and obesity in pregnancy.

RETRACTED ARTICLE: miR-134-5p promotes inflammation and apoptosis of trophoblast cells via regulating FOXP2 transcription in gestational diabetes mellitus

“…Previously, hyperglycaemic condition in GDM can evidently evoke a pro-inflammatory response in trophoblasts, thus exacerbation the degree of apoptosis of trophoblast cells [ 4 ]. The currently available treatments for the management of hyperglycemia fundamentally repair the inflammatory insult and trophoblast dysfunction induced by GDM [ 5 , 6 ]. However, drug therapeutics for the management of hyperglycemia present with varying degrees of maternal and infant complications, depending on factors such as age, physical condition, pregnancy stage, and complications [ 7 ] Therefore, the development of targeted methods is necessitated for the management of inflammation and apoptosis in trophoblasts for GDM treatment.…”

The Study of Malondialdehyde, Uric Acid, and C-Reactive Protein in Obese and Healthy Pregnant Women in Different Trimesters

“…CRP is a protein produced in response to inflammation to control it via activating the complementary immune system [44] , andprimarily synthesized in hepatocytes in response to infection and tissue injury [45] , therefore it's considered as asensitive marker of chronic inflammation and a risk factor for diabetesand mortality [46][47][48] .…”

Can Thyroid Screening in the First Trimester Improve the Prediction of Gestational Diabetes Mellitus?

“…This study did not examine the presence of anti-insulin antibodies to prove this association, as they are an autoimmune marker of pancreatic islet cell beta cell destruction [44] and can be detected years before clinical manifestations of DM in healthy individuals or in individuals with other autoimmune disorders such as autoimmune thyroiditis. Some authors believe that the link between the two is an autoimmune inflammatory process, citing elevated serum cytokine levels in both disorders [35,45,46]. Hashimoto's disease could be considered a T helper 1 disease in which pro-inflammatory cytokines play a crucial role, and there is a connection between the level of anti TPO antibodies and pro-inflammatory cytokines that appears at higher concentrations in individuals with insulin resistance [47].…”