Serum ferritin concentration in gestational diabetes mellitus and risk of subsequent development of early postpartum diabetes mellitus

Sharifi, Faranak; Ziaee, Amir; Feizi, Abdolamir; Mousavinasab, Seyed Nouraddin; Anjomshoaa, Afagh; Mokhtari, Pooran

doi:10.2147/dmso.s15049

Cited by 24 publications

(37 citation statements)

References 23 publications

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“…Our finding of a significant and positive association between ferritin levels and GDM is consistent with most [9-12, 18, 21-26] but not all previous studies [8, 27, 28]. Notably, the majority of prior studies were cross-sectional, using only a single measurement of ferritin, typically assessed at the time of GDM diagnosis [18,[21][22][23][24][25][26][27]. Peripheral circulating ferritin concentrations are a good proxy for body iron stores but, being an acute-phase reactant, ferritin levels can also increase with subclinical systemic inflammation, which is associated with insulin resistance in GDM [13].…”

Section: Discussionsupporting

confidence: 89%

“…In an experimental study in which iron-deficiency anaemia was gradually induced in healthy participants, serum ferritin levels declined as iron stores decreased, whereas circulating sTfR levels increased only once the iron stores had been significantly depleted. In our study sample, there were only a small number of women with suspected iron deficiency (three women at weeks 10-14 and 13 women at weeks [15][16][17][18][19][20][21][22][23][24][25][26], as defined by plasma ferritin levels less than 26.9 pmol/l [9]. Hence, sTfR levels alone might not have been an appropriate indicator of iron status in our sample.…”

Section: Discussionmentioning

confidence: 99%

“…The visits were targeted at gestational weeks 8-13 (enrolment), 16-22, 24-29 and 34-37, but the actual ranges were gestational weeks 10-14, 15-26, 23-31 and 33-39, respectively. Blood specimens were collected at the second visit (week [15][16][17][18][19][20][21][22][23][24][25][26], after an overnight fast. All biospecimens were immediately processed and stored at -80°C until being thawed for laboratory analysis.…”

Section: Methodsmentioning

confidence: 99%

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A longitudinal study of iron status during pregnancy and the risk of gestational diabetes: findings from a prospective, multiracial cohort

et al. 2016

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Aims/hypothesis The aim of this study was to prospectively and longitudinally investigate maternal iron status during early to mid-pregnancy, and subsequent risk of gestational diabetes mellitus (GDM), using a comprehensive panel of conventional and novel iron biomarkers. Methods A case-control study of 107 women with GDM and 214 controls (matched on age, race/ethnicity and gestational week during blood collection) was conducted within the the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort (2009)(2010)(2011)(2012)(2013), a prospective and multiracial pregnancy cohort. Plasma hepcidin, ferritin and soluble transferrin receptor (sTfR) were measured and sTfR:ferritin ratio was derived, twice before GDM diagnosis (gestational weeks 10-14 and 15-26) and at weeks 23-31 and 33-39. GDM diagnosis was ascertained from medical records. Adjusted ORs (aORs) for GDM were estimated using conditional logistic regression analysis, adjusting for demographics, prepregnancy BMI and other major risk factors. Results Hepcidin concentrations during weeks 15-26 were 16% higher among women with GDM vs controls (median 6.4 vs 5.5 ng/ml; p = 0.02 ), and were positively associated with GDM risk; the aOR (95% CI) for highest vs lowest quartile was 2.61 (1.07, 6.36). Ferritin levels were also positively associated with GDM risk; the aOR (95% CI) for highest vs lowest quartile was 2.43 (1.12, 5.28) at weeks 10-14 and 3.95 (1.38, 11.30) at weeks 15-26. The sTfR:ferritin ratio was inversely related to GDM risk; the aOR (95% CI) for highest vs lowest quartile was 0.33 (0.14, 0.80) at weeks 10-14 and 0.15 (0.05, 0.48) at weeks 15-26. Conclusions/interpretation Our findings suggest that elevated iron stores may be involved in the development of GDM from as early as the first trimester. This raises potential concerns for the recommendation of routine iron supplementation among iron-replete pregnant women.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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A longitudinal study of iron status during pregnancy and the risk of gestational diabetes: findings from a prospective, multiracial cohort

et al. 2016

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“…The overall result of oxidative reactions is an increase in the availability of free iron from the ferritin [11,13]. Iron influences insulin action and it interferes with insulin inhibition of glucose production by the liver [11,[14][15][16]. Hepatic extraction and metabolism of insulin are reduced with increasing iron stores, leading to peripheral hyperinsulinemia.…”

Section: Introductionmentioning

confidence: 99%

“…Hepatic extraction and metabolism of insulin are reduced with increasing iron stores, leading to peripheral hyperinsulinemia. In fact, the initial and most common abnormality seen in iron overload conditions is liver insulin resistance [11,15].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Serum-Free Iron and Glycated Hemoglobin in Uncontrolled Type-Ii Diabetic Patients

Kamalam

Ganesan

Anbazhagan

2016

Asian J Pharm Clin Res

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Objective: Diabetes mellitus (DM) is a common health problem in the world. Free iron may contribute to the pathogenesis and progress of this disease and its complication. Iron causes hyperinsulinemia by decreasing the insulin uptake and metabolism by hepatocytes. Elevated iron stores are commonly found in insulin resistance. Iron in its free form is known to induce oxidation of biomolecules by producing harmful hydroxyl radicals. In this study, we aimed to estimate and compare the serum levels of free iron in diabetes and healthy individuals.Methods: This study included 244 subjects in two groups. Group-I comprised 204 subjects with DM and Group-II comprised 40 healthy subjects. Blood sugar, free iron, and glycated hemoglobin were analyzed in blood samples using standard kits. The results of all the parameters were expressed as mean±standard deviation. Student t-test was done to assess the statistical significance between two groups. The association between the parameters was studied by Pearson correlation. Results:In this study, we found a significant increase in serum free iron in Group-I (p<0.01) when compared with Group-II. A significant correlation between the serum free iron and glycated hemoglobin (r=0.59; p<0.001) and fasting blood sugar (r=0.43; p<0.001). Conclusion:The elevated serum free iron in uncontrolled diabetes may contribute to oxidative stress which may be associated with complications of diabetes.

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Gestational diabetes mellitus in association with macrosomia in Iran: a meta-analysis

Tabrizi

Asemi

Lankarani

et al. 2019

J Diabetes Metab Disord

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Purpose This meta-analysis aimed to estimate the association between gestational diabetes mellitus (GDM) and occurrence of macrosomia for the first time among Iranian population. Methods A systematic review was done of national and international databases. Lists of relevant articles were checked to increase sensitivity of the search reference. Also, access to unpublished articles and documents were accessed by negotiation with related individuals and research centers. These published epidemiological studies (cross-sectional, case-control and cohort studies) were used for comparisons to determine whether GDM was associated with macrosomia. Finally, the Mantel-Haenszel method and the fixed and random-effect models based on heterogeneity of the primary studies were used according to pool results and estimate the odds ratio of macrosomia in women with GDM. Results Of 1870 articles, thirty relevant articles were eligible for the current meta-analysis. Our findings showed that 335 of 2524 women with GDM had macrosomia while only 775 of 26,592 women without GDM had macrosomia. Using random-effect model, the pooled odds ratio (OR) relation between GDM and occurrence of macrosomia was estimated as of 5.49 (95% CI: 4.27-7.04). Subgroup analysis showed no difference regarding different study designs and definitions of macrosomia. There was no evidence of publication bias based on the result of Egger's test (β = 0.1, P = 0.70). Conclusions This meta-analysis shows that GDM is directly associated with the risk of macrosomia in the Iranian population. This confirms the findings of previous studies in the wider scientific literature.

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Serum ferritin concentration in gestational diabetes mellitus and risk of subsequent development of early postpartum diabetes mellitus

Cited by 24 publications

References 23 publications

A longitudinal study of iron status during pregnancy and the risk of gestational diabetes: findings from a prospective, multiracial cohort

A longitudinal study of iron status during pregnancy and the risk of gestational diabetes: findings from a prospective, multiracial cohort

Evaluation of Serum-Free Iron and Glycated Hemoglobin in Uncontrolled Type-Ii Diabetic Patients

Gestational diabetes mellitus in association with macrosomia in Iran: a meta-analysis

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