scholarly journals Plasma Zonulin Levels as a Non-Invasive Biomarker of Intestinal Permeability in Women with Gestational Diabetes Mellitus

Biomolecules ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 24 ◽  
Author(s):  
Esra Demir ◽  
Hanise Ozkan ◽  
Kerem Doga Seckin ◽  
Berrak Sahtiyancı ◽  
Bulent Demir ◽  
...  

Objective: We aimed to compare the levels of plasma zonulin, a non-invasive biomarker of increased intestinal permeability, between pregnant subjects, with and without gestational diabetes mellitus (GDM), at 24–28 gestational weeks. The eighty-five consecutive pregnant subjects that presented to our hospital’s obstetrics outpatient clinic and were diagnosed with GDM, for the first time by an oral glucose tolerance test (OGTT), formed the GDM group; 90 consecutive subjects that were not diagnosed with GDM by OGTT, formed the control group. The diagnosis of GDM was made by an OGTT performed between the 24th and 28th weeks of gestation, and in compliance with the American Diabetes Association (ADA) criteria. Plasma zonulin levels were measured by the enzyme-linked immunosorbent assay (ELISA) methods. The Plasma zonulin level was significantly higher in the GDM group than the control group (p < 0.001). A correlation analysis showed that plasma zonulin level was positively correlated to body mass index (BMI), creatinine, fasting plasma glucose, baseline, first hour, and two hours glucose levels and the OGTT, hemoglobin A1C (HbA1C), homeostatic model assessment for insulin resistance (HOMA-IR), and alanine aminotransferase (ALT) levels. Our findings suggest that zonulin may be a non-invasive biomarker involved in the pathogenesis of GDM. Further large-scale studies are needed on this subject.

2019 ◽  
Vol 20 (1) ◽  
pp. 159 ◽  
Author(s):  
Radzisław Mierzyński ◽  
Elżbieta Poniedziałek-Czajkowska ◽  
Dominik Dłuski ◽  
Jolanta Patro-Małysza ◽  
Żaneta Kimber-Trojnar ◽  
...  

Gestational diabetes mellitus (GDM) is considered to be one of the most frequent medical complication observed among pregnant women. The role of adipokines in the pathogenesis of GDM remains strictly unknown. Different adipokines have been studied throughout gestation, and they have been proposed as biomarkers of GDM and other pregnancy-related complications; however, there is no biomarker reported for GDM screening at present. The aim of this study was to evaluate serum nesfatin-1 and vaspin levels in GDM and non-GDM women, to characterize the correlation between these adipokines, and to assess the potential role of circulating adipokines in the prediction of risk of gestational diabetes mellitus. Serum concentrations of nesfatin-1 and vaspin were measured in 153 women with GDM, and in 84 patients with uncomplicated pregnancy by enzyme-linked immunosorbent assay (ELISA) kits, according to the manufacturer’s instructions. Circulating levels of nesfatin-1 and vaspin were significantly lower in the GDM group than in the control group. Nesfatin-1 levels were negatively correlated with vaspin levels. The results of this study point out the possible role of nesfatin-1 and vaspin as potential novel biomarkers for the prediction and early diagnosis of GDM. Further studies are necessary to evaluate the influence of nesfatin-1 and vaspin on glucose metabolism in the early stages of GDM.


2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Xingjun Meng ◽  
Bo Zhu ◽  
Yan Liu ◽  
Lei Fang ◽  
Binbin Yin ◽  
...  

Background. Gestational diabetes mellitus (GDM) is a type of glucose intolerance disorder that first occurs during women’s pregnancy. The main diagnostic method for GDM is based on the midpregnancy oral glucose tolerance test. The rise of metabolomics has expanded the opportunity to better identify early diagnostic biomarkers and explore possible pathogenesis. Methods. We collected blood serum from 34 GDM patients and 34 normal controls for a LC-MS-based metabolomics study. Results. 184 metabolites were increased and 86 metabolites were decreased in the positive ion mode, and 65 metabolites were increased and 71 were decreased in the negative ion mode. Also, it was found that the unsaturated fatty acid metabolism was disordered in GDM. Ten metabolites with the most significant differences were selected for follow-up studies. Since the diagnostic specificity and sensitivity of a single differential metabolite are not definitive, we combined these metabolites to prepare a ROC curve. We found a set of metabolite combination with the highest sensitivity and specificity, which included eicosapentaenoic acid, docosahexaenoic acid, docosapentaenoic acid, arachidonic acid, citric acid, α-ketoglutaric acid, and genistein. The area under the curves (AUC) value of those metabolites was 0.984 between the GDM and control group. Conclusions. Our results provide a direction for the mechanism of GDM research and demonstrate the feasibility of developing a diagnostic test that can distinguish between GDM and normal controls clearly. Our findings were helpful to develop novel biomarkers for precision or personalized diagnosis for GDM. In addition, we provide a critical insight into the pathological and biological mechanisms for GDM.


2017 ◽  
Vol 11 (1) ◽  
pp. 25-28
Author(s):  
Farzana Akonjee Mishu ◽  
MA Muttalib

Background and objectives: Alteration of magnesium (Mg) and copper (Cu) concentrations in blood has been observed in normal pregnancy as well as in gestational diabetes mellitus (GDM). The present study was aimed to evaluate the serum Mg and Cu levels in Bangladeshi women with GDM in their second and third trimester of pregnancy.Methods: The study was conducted at Mymensingh Medical College Hospital from July 2013 to June 2014. Pregnant women, in their second and third trimester, attending the outpatient department of Obstetrics and Gynecology and the Department of Endocrinology of Mymensingh Medical College Hospital were enrolled by purposive sampling technique. GDM was diagnosed on the basis of oral glucose tolerance test (OGTT) as defined in WHO criteria 2013. Blood glucose was estimated by enzymatic GOD-PAP colorimetric method. The cut off value for fasting plasma glucose level was ?6.1 mmol/L or ?7.8 mmol/L 2 hours after glucose load. Serum Cu was estimated by 3, 5-DiBr-PAESA method and Mg by Xylidyl Blue-I Method as per manufacturer’s instruction.Results: A total of 172 pregnant women in their second and third trimester were enrolled. Out of 172 participants, 86 had GDM and 86 were normoglycemic (control). The mean age of GDM and control groups was 28.6±3.2 years and 27.3±3.1 years respectively. The BMI was 26.4±1.5 m/kg2 and 26.3±1.3 m/kg2. Serum Mg level was significantly low (p< 0.001) in 2nd and 3rd trimesters in GDM cases (1.39±0.26 mg/dl and 0.93±0.15 mg/dl) compared to control group (1.67±0.3 mg/dl and 1.67±0.31mg/dl). On the contrary, serum Cu levels in GDM cases were significantly (p<0.002) higher in both trimesters (224±333.8 ?g/dl and 243.91±6.89 ?g/dl) compared to those without GDM (220.1±7.6 ?g/dl and 234.9±4.6 ?g/dl). There was significant (p<0.001) increase of serum Cu levels in 3rd trimester compared to 2nd trimester in both GDM and non GDM cases.Conclusion: There was distinct alteration of serum Mg and Cu levels in GDM compared to normal pregnancy.IMC J Med Sci 2017; 11(1): 25-28


2016 ◽  
Vol 19 (2) ◽  
pp. 150-157 ◽  
Author(s):  
Tatiana V. Saprina ◽  
Ekaterina S. Timokhina ◽  
Olga K. Goncharevich ◽  
Svetlana V. Budeeva ◽  
Tatiana S. Prokhorenko ◽  
...  

Background: Enteropancreatic hormonal system disorder is a possible reason for β-cell dysfunction and carbohydrate metabolism disorder among pregnant women. However, no information is available about the state of enteroinsulin hormones [glucagon, glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide1 (GLP-1) and GLP-2] during pregnancy. The role of enteroinsulin hormones in the development of carbohydrate metabolism disorder during pregnancy is poorly understood. Aim: To quantify and compare incretin hormone secretion in groups of pregnant women with and without gestational diabetes mellitus (GDM). Materials and methods: The study included 80 patients, 50 of whom had GDM, and the control group consisted of 30 pregnant women without GDM. All patients underwent an oral glucose tolerance test; glycated haemoglobin (HbA1c) estimation; ferritin, transferrin, basal and postprandial glucagon estimation; GLP-1 and GLP-2 estimation. Results: Basal glucagon and GLP-1 levels were significantly higher (p 0. 05) in the group of women with GDM than in the control group. The most significant differences in GLP-1, basal and postprandial glucagon levels were observed during the first trimester of pregnancy. Conclusion: High GLP-1 levels in the group of women with GDM may reflect a state of ‘incretin resistance’, which is similar to hyperinsulinemia in the early stages of type 2 diabetes mellitus. 


Author(s):  
Sukesh R. S. ◽  
Laxmy Rajmohan

Background: Gestational diabetes mellitus is common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. The present study aimed to know association between physical activity and gestational diabetes mellitus in the first 20 weeks of their pregnancy.Methods: In the current case-control study, 50 pregnant females with gestational diabetes mellitus as the case group and 50 pregnant females as control group were selected. To diagnose gestational diabetes mellitus using diagnostic criteria. Females with abnormal oral glucose challenge test (>140mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by pregnancy physical activity questionnaire. Anthropometric and other data were recorded for all of the participants.Results: Females with low total physical activity at early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus compared to the ones with higher levels of physical activity. After adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. Females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus compared to females with a higher intensity of sedentary, light and moderate physical activity.Conclusions: Females should be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it. 


2017 ◽  
Vol 20 (1) ◽  
pp. 85-92
Author(s):  
Polina Viktorovna Popova ◽  
Aleksandra Sergeevna Tkachuk ◽  
Yana Alexeevna Bolotko ◽  
Andrey Sergeevich Gerasimov ◽  
Ksenia Alexandrovna Demidova ◽  
...  

Background. Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It can cause significant problems for the mother and offspring, such as caesarean delivery, birth trauma and the development of type 2 diabetes mellitus (T2DM) in the future. The identification and correction of modifiable risk factors for GDM will provide a possibility to prevent these complications. Aim. This study aimed to identify the most significant lifestyle parameters affecting the risk of developing GDM. Methods. The study included 680 pregnant women who underwent oral glucose tolerance test at 2432 weeks of pregnancy and responded to a questionnaire comprising the following sections stratified in a semi-quantitative manner: the consumption of major food groups and drinks and the amount of physical activity and smoking before and during pregnancy. A logistic regression analysis was performed to identify lifestyle parameters that influence GDM development. GDM was diagnosed according to the IADPSG criteria. Results. GDM was diagnosed in 266 women; the other 414 women formed the control group. The most significant dietary risk factor for developing GDM was the consumption of sausage(s), dried fruits and fresh fruits. Eating sausage(s) more than thrice a week during pregnancy increased the risk of developing GDM by 2.4 times [95% confidence interval (CI), 1.53.8; p 0.001] and so did the consumption of dried fruits more than thrice a week during pregnancy [odds ratio (OR), 6.5; 95% CI, 2.516.8; p 0.001)] compared with the risk of GDM by less consumption of these food groups. A regular consumption of fresh fruits more than 12 times a week during pregnancy reduced the risk of GDM (OR, 0.5; 95% CI, 0.30.8; p = 0.015). The habit of climbing at least four floors per day during pregnancy also reduced the risk of GDM (OR, 0.7; 95% CI, 0.51.0; p = 0.069). Conclusions. The recommendations for GDM prevention should include limiting the consumption of sausage(s) and dried fruits, increasing the consumption of fresh fruits and introducing regular physical activities, such as climbing stairs.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Shimin Hu ◽  
Shujuan Ma ◽  
Xun Li ◽  
Zhengwen Tian ◽  
Huiling Liang ◽  
...  

Background. Solute carrier family 2 member 4- (SLC2A4-) retinol binding protein-4- (RBP4-) phosphoenolpyruvate carboxykinase 1 (PCK1)/phosphoinositide 3-kinase (PI3K) is an adipocyte derived “signalling pathway” that may contribute to the pathogenesis of type 2 diabetes mellitus (T2DM). We explored whether single nucleotide polymorphisms (SNPs) of these “signalling pathway” genes are associated with gestational diabetes mellitus (GDM). Methods. Case-control studies were conducted to compare GDM and control groups. A total of 334 cases and 367 controls were recruited. Seventeen candidate SNPs of the pathway were selected. Chi-square tests, logistic regression, and linear regression were used to estimate the relationships of SNPs with GDM risk and oral glucose tolerance test (OGTT), fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) levels. Model-based multifactor dimensionality reduction was used to estimate the adjusted interactions between genes. Regression and interaction analyses were adjusted by maternal age, prepregnancy BMI, and weekly BMI growth. The Bonferroni correction was applied for multiple comparisons. Results. RBP4 rs7091052 was significantly associated with GDM risk. SLC2A4 rs5435, RBP4 rs7091052, PCK1 rs1042531 and rs2236745, and PIK3R1 (coding gene of the PI3K P85 subunit) rs34309 were associated with OGTT, fasting insulin, and HOMA-IR levels in the linear regression analysis. The gene-gene interaction analysis showed that, compared with pregnant women with other genotype combinations, women with SLC2A4 rs5435 (CC/CT), RBP4 rs7091052 (CC), PCK1 rs1042531 (TT/TG) and rs2236745 (TT), and PIK3R1 rs34309 (AA) had lower GDM risk. Conclusion. SLC2A4, RBP4, PCK1, and PIK3R1 genes may be involved in the pathogenesis of GDM.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paola Quaresima ◽  
Federica Visconti ◽  
Fabiana Interlandi ◽  
Luigi Puccio ◽  
Patrizia Caroleo ◽  
...  

Abstract Background Gestational diabetes mellitus (GDM) incidence is increasing worldwide. It represents a major risk factor for adverse foetal-maternal outcomes. Awareness among women in regard to GDM-related risks (in particular foetus ones) has been proven to have an impact on compliance with recommendations. Therefore we aimed to evaluate the efficacy of our post-diagnosis counselling, that informs affected women of the GDM related risks for complications, in determining an adequate level of understanding. Method This is a cohort study involving 400 women undergoing the 24-28 weeks 75 g oral glucose tolerance test. Two hundred women diagnosed with GDM received the post-diagnosis counselling (treatment group) and two hundred women diagnosed without did not receive any counselling (control group). Both populations were surveyed with a 5 question questionnaire regarding their awareness about GDM foetal-maternal related risks. Their level of education about GDM foetal-maternal related risks, estimated according to the number of correct answers, was scored as: primary (score 0-1), secondary (score 2-3) or tertiary (score 4-5). Results Most of the women in the treatment group after receiving the post-diagnosis counselling have demonstrated a secondary level of education 132/200 (66%). Their mean level of awareness was higher in comparison to the control group 2.6 ± 1.8 (SD) versus 2.14 ± 1.8 (SD) p value = 0.012. In particular, they’ve demonstrated to be more aware of the risks for the foetus to become macrosomic (p = 0.004) or to die in utero (p = 0.0001). A high level of education and to have had previous pregnancies positively affected correct answers. Conclusions Our post-diagnosis counselling has played a role in improving women awareness about GDM foetal-maternal related risks. Future study will explore the impact of women’s level of awareness on glycaemic control.


2019 ◽  
Vol 110 (3) ◽  
pp. 750-758 ◽  
Author(s):  
Yuhang Chen ◽  
Huikun Liu ◽  
Leishen Wang ◽  
Tao Zhou ◽  
Zhaoxia Liang ◽  
...  

ABSTRACTBackgroundA history of gestational diabetes mellitus (GDM) has been related to an elevated risk of type 2 diabetes. The melanocortin-4 receptor (MC4R) genotype has been related to glycemic changes in women with prior GDM.ObjectiveThe objective of this study was to analyze whether lifestyle intervention modified the association between the MC4R genotype and changes in insulin sensitivity among women with prior GDM.MethodsWe genotyped MC4R rs6567160 and measured glucose and insulin in fasting plasma samples at baseline and during the first 2 follow-up visits in 1128 women with prior GDM. They were randomly assigned to either a 4-y lifestyle intervention involving both diet and physical activity or a control group from a randomized clinical trial, the Tianjin Gestational Diabetes Mellitus Prevention Program. We analyzed the interaction between the MC4R genotype and lifestyle intervention on changes in insulin resistance.ResultsFrom baseline to 1.28 y, the MC4R genotype was related to changes in fasting insulin, HOMA-IR, and homeostasis model assessment of β cell function (HOMA-B) in the intervention group. Each risk allele (C) of rs6567160 was associated with a 0.08-unit greater decrease in log(insulin), log(HOMA-IR), and log(HOMA-B) (P = 0.02, 0.04, and 0.04, respectively), whereas in the control group, each C allele tended to be associated with a greater increase in HOMA-IR (P = 0.09). We found significant interactions between the MC4R genotype and lifestyle intervention on 1.28-y changes in fasting insulin and HOMA-IR (P = 0.006 and 0.008, respectively), and such interaction remained significant when we analyzed the trajectory of changes in insulin and HOMA-IR from baseline to 2.55 y (both P = 0.03).ConclusionsThe exploratory results from the first 2 follow-up visits indicate that women with prior GDM carrying a diabetes-increasing MC4R genotype (CC or TC) may obtain better improvement than the TT genotype in insulin resistance through lifestyle intervention. This trial was registered at clinicaltrials.gov as NCT01554358.


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