Serum levels of nesfatin-1 are increased in gestational diabetes mellitus

Objective: To analyze the concentrations of nesfatin-1 in maternal and cord serum, to evaluate the expression of nesfatin-1 in subcutaneous adipose tissue (SAT) from pregnant women with gestational diabetes mellitus (GDM) and those with normal glucose tolerance (NGT).

Methods: We studied a total of 50 GDM and 50 NGT subjects. The clinical features, serum nesfatin-1, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profiles were measured at the third trimester of pregnancy. The expression of nesfatin-1 in the SAT was determined by western blot.

Results: Compared with the NGT group, the GDM group showed greater levels of serum nesfatin-1, adipocyte fatty acid binding protein (AFABP), and leptin; a greater level of cord blood nesfatin-1; and a higher level of expression in SAT (p?p?b?=?0.317, p=?0.022) and body mass index (BMI) before delivery (b?=?0.367, p=0.008) were independently associated with serum nesfatin-1. Nesfatin-1 was the independent risk factor for GDM.

Conclusions: The GDM group had higher levels of maternal serum and cord blood nesfatin-1, and greater nesfatin-1 expression in SAT. Nesfatin-1 is closely related to obesity and IR in pregnancy.     

Maternal serum atrial natriuretic peptide (ANP) and brain-type natriuretic peptide (BNP) levels in gestational diabetes mellitus

Objective: The aim of the study is to evaluate maternal serum atrial natriuretic peptide (ANP) and brain-type natriuretic peptide (BNP) levels in patients with getational diabetes mellitus compared with a control group.

Methods: We have measured maternal serum ANP and BNP levels in 35 otherwise healthy and 45 gestational diabetic women between gestational week 24 and 28 referred to our unit in a cross-sectional study. Independent samples t-test or the Mann–Whitney U-test was used for comparison of two groups where appropriate.

Results: Mean maternal serum homeostasis model assessment of insulin resistance (HOMA-IR), HbA1c, fasting glucose and insulin levels in gestational diabetes mellitus (GDM) group were significantly higher than the control group (p?<?0.01). Mean maternal serum ANP and BNP levels of women with GDM were significantly lower than the control group (12.9?±?9.9 versus 34.8?±?16.9?pg/ml, p?<?0.001; 416.6?±?209.7 versus 629.7?±?162.2?mg/dl, p?<?0.001, respectively). Maternal serum ANP and BNP levels were negatively correlated with insulin levels, HbA1c and HOMA-IR values (p?<?0.05).

Conclusions: Maternal serum ANP and BNP levels are significantly lower in patients with GDM. These biomarkers might be valuable in clinical setting for identifying high-risk women for developing diabetes during pregnancy.     

Impact of pre-gravid body mass index and body mass index change on preeclampsia and gestational diabetes in singleton and twin pregnancies

Abstract

Objective: To examine pre-gravid body mass index (BMI) and gestational BMI change impact on preeclampsia and gestational diabetes mellitus (GDM).

Methods: Retrospective population-based cohort study. Data from Slovenian National Perinatal Information System were analyzed for the period 2002–2011. Three singleton controls were matched by parity and maternal age to each twin pregnancy delivered at >36 weeks. Student’s t test was used to compare pre-gravid BMI and gestational BMI change in different groups (p?<?0.05 significant).

Results: 2046 twin and 6138 singleton pregnancies were included. Twin and singleton patients with preeclampsia or GDM had higher pre-gravid BMI (p?<?0.001). Gestational BMI change was smaller in twins with GDM (p?<?0.001), and not associated with preeclampsia (p?=?0.07). Smaller gestational BMI change in singleton pregnancies was associated with GDM (p?<?0.001), and greater BMI change with preeclampsia (p?=?0.004).

Conclusions: Pre-gravid BMI is more strongly associated with preeclampsia and GDM in twin and singleton pregnancies than gestational BMI change. Smaller gestational BMI change in GDM pregnancies reflect the importance of dietary counseling.     

The effects of probiotic supplementation on biomarkers of inflammation,oxidative stress and pregnancy outcomes in gestational diabetes

Objective: This study was designed to evaluate the effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes among subjects with gestational diabetes (GDM).

Methods: This randomized, double-blind, placebo-controlled clinical trial was done among 60 subjects with GDM who were not on oral hypoglycemic agents. Patients were randomly allocated to intake either probiotic capsule containing Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum (2?×?10⁹ CFU/g each) (n?=?30) or placebo (n?=?30) for six?weeks.

Results: Compared with the placebo, probiotic supplementation resulted in significant decreases in fasting plasma glucose (FPG) (?5.3?±?6.7 vs.?+0.03?±?9.0?mg/dL, p?=?.01), serum high-sensitivity C-reactive protein (hs-CRP) (?2.2?±?2.7 vs.?+0.5?±?2.4?μg/mL, p?p?=?.03) and MDA/TAC ratio (?0.0003?±?0.0008 vs.?+0.0009?±?0.002, p?=?.004), and a significant increase in total antioxidant capacity (TAC) levels (+65.4?±?103.3 vs. ?37.2?±?143.7?mmol/L, p?=?.002). Probiotic supplementation did not affect pregnancy outcomes.

Conclusions: Overall, probiotic supplementation among women with GDM for six?weeks had beneficial effects on FPG, serum hs-CRP, plasma TAC, MDA and oxidative stress index, but did not affect pregnancy outcomes.     

Neopterin and hsCRP are not correlated in gestational diabetes mellitus

Objective: To determine serum neopterin and high sensitive C-reactive protein (hsCRP) levels in patients with and without gestational diabetes mellitus (GDM).

Methods: Neopterin and hsCRP levels were quantified in 28 women with GDM and 20 pregnant women with normal glucose tolerance (NGT). Postpartum neopterin and hsCRP levels were measured in a follow-up study.

Results: Neopterin levels were significantly higher in women with GDM than in women with NGT (15.89?±?8.19?nmol/L versus 10.4?±?3.8?nmol/L, p?p?p?=?0.9, respectively). In contrast, hsCRP levels decreased after delivery in patients with GDM (5.74?±?3.91 versus 3.78?±?2.78, p?r?=?0.3, p?=?0.02) and fasting glucose (r?=?0.4, p?=?0.004), postprandial glucose (r?=?0.3, p?=?0.01), HbA1c (r?=?0.3, p?=?0.02), whereas hsCRP levels were correlated with pre-pregnancy (r?=?0.3, p?=?0.04) and pregnancy body mass index (r?=?0.4, p?=?0.008). No correlation between serum neopterin and hsCRP levels was found (p?=?0.9).

Conclusion: Neopterin levels increased in patients with GDM; hence, it may be related to inflammation. However, the lack of correlation between neopterin and hsCRP suggests the role of different attitudes of these two parameters in the course of pregnancy and GDM.     

Clinical significance of neuregulin 4 (NRG4) in gestational diabetes mellitus

Objective: Gestational diabetes mellitus (GDM) is defined as glucose intolerance detected during pregnancy. GDM is increasing worldwide and is associated with adverse maternal and fetal outcomes. Neuregulin 4 (NGR4) is epidermal growth factor like signaling molecule. It plays an important role in cell to cell communication furthermore recent studies indicate that NRG4 may work as a novel adipokine with a possible role in maintaining energy and metabolic homeostasis. The aim of the present study was to assess serum NRG4 levels along with several metabolic parameters in patients diagnosed with gestational diabetic mellitus.

Materials and methods: In this prospective cross-sectional study, the study group was composed of 63 women with GDM and 64 healthy pregnant women matched for age, body mass index (BMI) and gestational age. Blood samples were collected at the 24–28th gestational weeks. Serum NRG4, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides, glucose levels during 75-gr OGTT, fasting insulin, glycosylated hemoglobin A1c (HbA1c), alanine aminotransferase (ALT) and creatinine levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) values were calculated.

Results: Serum NRG4 values were significantly elevated in the GDM group compared to the control group (p?β?=?0.910, p?β?=?0.866, p?β?=?0.222, p?Conclusions: Serum NRG4 levels were associated with metabolic parameters of GDM. The present study can be considered to be a guide for future studies to clarify the pathophysiology of NGR4 in GDM patients.     

Relationship between advanced glycation end products and gestational diabetes mellitus

Objective: To investigate the levels of and dynamic changes of advanced glycation end products (AGEs) in maternal plasma during pregnancy and explore the association between these levels and gestational diabetes mellitus (GDM).

Methods: This study recruited 90 GDM women and 90 healthy pregnant controls. The women received prenatal care and were hospitalized for delivery in Peking University First Hospital in China between October 2015 and April 2016. The patients were recruited and provided blood samples during gestational weeks 24–29. The levels of AGEs, TNF-α, hs-CRP, plasma glucose, and FINS and lipid profiles were measured, and HOMA-IR was calculated. New blood samples were collected and AGE was measured again in the two groups at 33–41 weeks of gestation to identify its dynamic changes.

Results: The levels of AGEs were significantly higher in the GDM group than in the NGT group at both 24–29 weeks (473.65?±?105.32 versus 324.36?±?57.86?ng/L; p?p?p?p?=?.003), TNF-α (p?=?.005), and hs-CRP (p?p?=?.001). In the NGT group, there was no significant change in the concentration of AGEs between the two gestational periods (p?=?.388).

Conclusions: Plasma levels of AGEs are associated with GDM. During pregnancy, the changes observed in the levels of AGEs were different between GDM and normal pregnancies.     

Serum adiponectin during pregnancy and postpartum in women with gestational diabetes and normal controls

Aims. To investigate changes in serum adiponectin during pregnancy and postpartum and assess its relationship with insulin resistance as measured by homeostasis model assessment (HOMA-IR).

Methods. Twenty-two normal pregnant women were compared with 22 women diagnosed with gestational diabetes mellitus (GDM). Serum adiponectin levels were measured at the time of the glucose challenge test as well as in the immediate postpartum period and the correlation of adiponectin to HOMA-IR was performed.

Results. Adiponectin was significantly lower in women with GDM than in controls during pregnancy (5381 vs. 8449 ng/dl, p = 0.004), as well as postpartum (3278 vs. 6958 ng/ml, p = 0.002). A significant reduction in adiponectin (3278 vs. 5381 ng/ml, p = 0.002) was observed postpartum in GDM women but not in controls. Using a lower cut-off value of 5253 ng/ml, maternal adiponectin could exclude GDM with a sensitivity of 86.4% and a specificity of 59.1% (area under the curve = 0.752, standard error = 0.77, 95% confidence interval 0.601–0.903, p = 0.004). Adiponectin levels during pregnancy were negatively correlated with HOMA-IR (r = ?0.375, p = 0.012).

Conclusion. GDM is associated with decreased serum adiponectin levels both in pregnancy as well as postpartum. Adiponectin is negatively correlated to HOMA-IR. A reduction in maternal adiponectin after delivery indicates a significant placental contribution to adiponectin production.     

Irisin as an early marker for predicting gestational diabetes mellitus: a prospective study

Objective: The objective of this study is to evaluate maternal serum irisin levels in the first and second trimesters of pregnancy in women diagnosed with and without gestational diabetes mellitus (GDM).

Methods: We performed a prospective, nested case–control study in 258 pregnant women who were enrolled at the time of the first prenatal visit (6–11th weeks of gestation) and followed until delivery. Among the entire population, we selected 20 women who subsequently developed GDM and 30 women with uneventful pregnancies. Blood samples were collected once from each participant at 6–11th weeks of gestation during the fetal viability scan and at 24–28th weeks of gestation during screening for GDM.

Results: In the first trimester, irisin levels were significantly lower in women who later developed GDM (median?=?453?ng/mL, range: 257–811?ng/mL) than in controls (median?=?721?ng/mL, range: 700–786?ng/mL). In the second trimester, the difference in irisin levels between the GDM group (median?=?749?ng/mL; range: 456–910?ng/mL) and controls (median?=?757?ng/mL; range: 703–898?ng/mL) was not statistically significant.

Conclusions: Irisin may be a useful biomarker in early pregnancy to predict the development of GDM.     

Second trimester maternal plasma and amniotic fluid adipokines in women who will develop gestational diabetes mellitus

Abstract

Objective: To study the adipokines concentration and glucose homoeostasis in the early-second trimester of women who will develop gestational diabetes mellitus (GDM).

Materials and methods: Maternal plasma and fetal amniotic fluid samples were prospectively collected between 2006 and 2007 at the time of mid-trimester amniocentesis. Eight patients found to be affected by GDM were compared with 10 control patients with a normal pregnancy course. Adipokines leptin and adiponectin, as well as insulin and glucose concentration both in amniotic fluid and maternal plasma were compared between cases and controls. HOMA-IR (homeostatic model assessment for insulin resistance) was also calculated both for amniotic fluid and maternal serum.

Results: The amniotic fluid adiponectin concentration was higher in women who would develop GDM than in controls (29.9?ng/ml, 95% CI 26.7–49.8 ng/ml, versus 14.9 ng/ml, 95% CI 13.5–18.8 ng/ml), p?<?0.05). No difference was shown for leptin both in amniotic fluid and maternal serum. Insulin concentrations in the amniotic fluid were found to be lower in GDM than in controls, while HOMA-IR-index resulted lower in amniotic fluid and higher maternal serum (p?<?0.05).

Conclusions: Our data suggests that an earlier alteration in the fetal glucose metabolism will precede the glucose dysmetabolism in pregnancies later complicated by GDM.     

Circulating galanin and IL-6 concentrations in gestational diabetes mellitus

Objective: The aim of this study is to compare galanin and IL-6 levels in pregnant women with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT). Also association of insulin resistance markers, galanin and IL-6 was investigated.

Materials and Methods: The study registered 30 pregnant women with GDM and 30 pregnant women with NGT. Fasting venous blood samples were collected from all patients. Galanin and IL-6 levels were measured by an enzyme-linked immunosorbent assay.

Results: Galanin and IL-6 levels were found higher in pregnant women with GDM (p?r?=?0.240, p?=?0.065), insulin (r?=?0.681, p?r?=??0.644, p?r?=?0.783, p?r?=?0.745, p?r?=?0.058, p?=?0.662), body mass index (r?=??0.019, p?=?0.886).

Conclusion: Galanin and IL-6 were found to be significantly associated with insulin resistance markers in GDM, thus may play important roles in regulation of glucose hemostasis.     

Prediction of gestational diabetes mellitus by first trimester serum secreted frizzle-related protein-5 levels

Objective: The main aim of this study was to investigate the first trimester maternal serum secreted frizzle-related protein-5 (Sfrp-5) levels and to evaluate the predictive value on the subsequently developed gestational diabetes mellitus (GDM).

Methods: A total of 40 pregnant women who subsequently developed GDM and 44 age- and pre-pregnancy BMI-matched healthy pregnant women were enrolled in this prospective case-control study. First trimester serum Sfrp-5 levels were evaluated to determine if there is an association with the onset of GDM, by using logistic regression analysis.

Results: Decreased first trimester serum Sfrp-5 levels (OR?=?14.332, 95%CI: 4.166–49.301, p?<?0.001) were found to be significantly associated with the increased risk of GDM. There were no statistically significant differences in serum Sfrp-5 levels between the diet- and insulin-treated GDM groups and also serum Sfrp-5 levels were not found to be predictive for adverse perinatal outcomes (p?>?0.05).

Conclusions: Decreased first trimester serum Sfrp-5 levels are significantly associated with the increased risk of GDM.     

Maternal serum ADAMTS-9 levels in gestational diabetes: a pilot study

Objective: Gestational diabetes mellitus (GDM) is characterized with insulin resistance which is diagnosed during pregnancy. Although pregnancy is a diabetogenic state, not all women develop GDM. Genetic factors together with enviromental factors cause the maladaptation of maternal pancreas to this diabetogenic state and GDM develops. ADAMTS-9 is a recently recognized molecule whose genetic variants have risk of GDM. Decreased levels have already been shown in fetal membranes. Maternal serum levels of this protein have not been studied yet. We hypothesized that the alteration of ADAMTS-9 expression should cause changes in maternal serum levels which further could help to identify the disease and develop new treatment strategies.

Materials and methods: This prospective case–control study is consisted of 27 pregnancies with GDM and 30 healthy singleton pregnancies matched for matenal age, gestational week, and maternal weight. GDM diagnosis was made with 2-h 75?g oral glucose tolerance test. ADAMTS-9 levels were compared between groups.

Results: ADAMTS levels were 3.62?±?0.33?ng/dL (range: 3.04–4.23) in GDM group and 4.65?±?1.70?ng/dL (range: 3.07–8.21) in control group (p?Conclusion: ADAMTS-9 levels were significantly lower in GDM pregnancies. This may help to understand the mechanism of GDM pathogenesis. In future, target treatments with ADAMTS proteins may help to improve the severity of diabetes pathogenesis.     

Low potassium level during the first half of pregnancy is associated with lower risk for the development of gestational diabetes mellitus and severe pre-eclampsia

Objective.?To examine the association between potassium level during the first half of pregnancy and the development of gestational diabetes mellitus (GDM) and hypertensive disorders in the second half of the pregnancy.

Methods.?The study population included all registered births between the years 2001–2007. The potassium levels during the first half of pregnancy were sorted by the following groups: K?<?3.5 mEq/l; K?=?3.5–3.99?mEq/l; and K?≥?4?mEq/l. The linear by linear χ²-test was used to determine the association between potassium level during the beginning of pregnancy and pregnancy complications.

Results.?The study population included 8114 deliveries. A significant linear association was documented between potassium level in the first half of the pregnancy and the prevalence of GDM in the second half of the pregnancy: 6.3% in the K?<?3.5?mEq/l group, 6.6% in the K?=?3.5–3.99?mEq/l group and 8.2% in the K?>?4?mEq/l group; (p?=?0.008). A statistically significant for lower rates of severe pre-eclampsia was noted between the groups: 0.4% in the K?<?3.5?mEq/l group, 0.9% in the K?=?3.5–3.99?mEq/l group, 1.3% in the K?=?4.0–4.99?mEq/l group and 1.5% in the K?≥?5?mEq/l group, (p?=?0.027). Indeed, K?>?5?mEq/l was noted as a significant risk factor for both, severe pre-eclampsia and for GDM. Using two multiple logistic regression models controlling for maternal age, potassium level was noted as an independent risk factor for both GDM and severe pre-eclampsia.

Conclusions.?High potassium levels during the first half of pregnancy are associated with higher risk for the development of GDM and severe pre-eclampsia.     

Haemostatic and cytokine changes in gestational diabetes mellitus

Background.?Limited data indicate the existence of a hypercoagulable state and the possible involvement of pro-inflammatory cytokines in the pathogenesis of gestational diabetes mellitus (GDM).

Aim.?To characterise the coagulation inhibitor and cytokine profiles in women with GDM.

Methods.?Two groups of women in the third trimester of pregnancy were studied: GDM (n?=?150) and controls: women with normal pregnancy (n?=?100); GDM in their first post-delivery day (n?=?52).

Laboratory assays.?Plasma fibrinogen, antithrombin (AT), protein C, total and free protein S, interleukins-2, 6 and 8 (IL-2, 6, 8).

Results.?During pregnancy, the only significant alterations noted were higher levels of body mass index, fibrinogen and total protein S in women with GDM when compared to normal pregnancy. In the post-delivery group, there was further elevation in the levels of plasma fibrinogen and significant drop in the level of total protein S, protein C and AT. Significant elevation of IL-2 and IL-6 levels was recorded only in post-delivery group.

Conclusion.?In GDM, the only indicator of a tendency towards hypercoagulability is the higher fibrinogen levels as compared to normal pregnancy. This feature along with the higher body mass index and presumed associated insulin resistance suggests that GDM may be a mild form of the metabolic syndrome. The lack of significant change in the levels of pro-inflammatory cytokines do not support the existence of an inflammatory state in GDM.     

Effect of vitamin D deficiency on the 75 g oral glucose tolerance test screening and insulin resistance

Abstract

Gestational diabetes mellitus (GDM), is the most common medical complications of pregnancy. This study aimed to clarify the effect of second-trimester vitamin D deficiency on the 75?g oral glucose tolerance test (OGTT) screening and insulin resistance. A total of 120 pregnant women with a singleton pregnancy at a gestational age of 26–28?weeks were analyzed. Participants were divided into two groups according to 25-hydroxyvitamin D levels; vitamin D deficiency, and control groups. For GDM scan, 75?g OGTT was preferred. GDM prevalence was 17.5% in vitamin D deficiency group and 13.75% in control group, there is no significant difference in GDM prevalence (p?=?0.149). Fasting plasma glucose and 1-h plasma glucose levels were significantly higher in the vitamin D deficiency group than in the control group (p?<?.001 and p?<?.001, respectively). No significant differences were observed between 2-hour plasma glucose levels (p?=?.266). The HOMA-IR level was significantly higher in the vitamin D deficiency group than in the control group (p?<?.001). The findings of the present study suggested that vitamin D deficiency in the second trimester was inversely correlated with fasting and 1-h plasma glucose after 75?g glucose challenge test; also, low 25 OHD₃ levels were associated with insulin resistance.     

Serum hepcidin is associated with parameters of glucose metabolism in women with gestational diabetes mellitus

Abstract

Objectives: Hepcidin is considered a major regulator of iron metabolism. Despite previous studies showing elevated ferritin and hepcidin levels in type 2 diabetes mellitus (DM), no study has investigated hepcidin levels in pregnant women with gestational DM (GDM).

Methods: A case-control study was conducted in 30 cases of GDM, 47 pregnant women with impaired glucose tolerance (IGT) and 72 pregnant women with normal glucose tolerance (control) between April 2009 and July 2011. Serum hepcidin and other iron metabolism parameters were analyzed in all groups.

Results: Serum ferritin and serum iron were significantly elevated in the GDM group compared to controls (p?=?0.014, p?=?0.018, respectively) and to the IGT group (p?=?0.021, p?=?0.008, respectively). Hepcidin levels were elevated significantly in the diabetic patients compared to the IGT group (p?=?0.011) and controls (p?=?0.002). We found no correlation between hepcidin and other iron metabolism parameters (Hb, serum iron and ferritin), whereas positive correlations were found between hepcidin and parameters of glucose metabolism (fasting blood glucose, fasting insulin level and glucose value response to glucose challenge test).

Conclusions: Serum hepcidin concentrations were increased in pregnant women with IGT and GDM and this was not related to inflammation parameters.     

Colostrum and mature breast milk analysis of serum irisin and sterol regulatory element-binding proteins-1c in gestational diabetes mellitus

Background: We aimed to evaluate irisin and SREBP-1c levels in serum, colostrum and mature breast milk in women with and without gestational diabetes (GDM); and to relate them with maternal glucose, lipid profile and weight status of babies.

Methods: GDM positive women (n?=?33) and normal glucose tolerant women (NGT) (n?=?33) were recruited. Maternal blood samples were collected at 28th week of gestation and later at 6-week post-partum while breast milk samples of the lactating mothers were collected within 72?hours of birth (colostrum) and at 6 weeks post-partum (mature milk). Irisin and SREBP-1c levels were analyzed by commercially available ELISA kits for all maternal samples.

Results: Lower levels of irisin were seen in serum, colostrum and mature breast milk of GDM females (p?r?=?0.439; p?r?=?0.403; p?=?.01), HbA1c (r?=??0.312; p?=?.011), Fasting blood glucose (r?=?0.992; p?=?.008), and baby weight at birth (r?=?0.486; p?r?=?0.325; p?=?.017; r?=?0.296; p?=?.022, respectively). Serum SREBP-1c at 6 weeks correlated with random blood glucose (r?=?0.318; p?=?.009), and HbA1c (r=??0.292; p?=?.011). All correlations were lost once we adjusted for maternal BMI.

Conclusions: Low irisin and SREBP1-c levels may favor development of GDM in pregnant subjects. Further, low mature breast milk levels may act as a continued stressor from fetal to infant life as long as breast-feeding is continued. Further studies are required to identify the mechanistic relationship between these biomarkers and GDM.     

A comparative analysis of maternal and fetal 25-hydroxyvitamin D in pregnant women with and without gestational diabetes mellitus

Objective: This study aimed to compare maternal 25-hydroxyvitamin D (25(OH)D) serum levels during pregnancy in women with and without gestational diabetes mellitus (GDM) with neonatal 25(OH)D serum levels and to evaluate the relationship between maternal and fetal 25(OH)D in the two groups.

Methods: Between May 2014 and March 2015, 87 pregnant women were enrolled. The study population was divided into two groups, those with and without GDM (n?=?32 and 55). All participants were surveyed about lifestyle and behavior. Maternal and umbilical venous blood samples were obtained. Serum from maternal blood was analyzed for 25(OH)D₂ and 25(OH)D₃, and umbilical venous blood for 25(OH)D₂, 25(OH)D₃, and 3-epi-25(OH)D₃.

Results: The maternal serum level of 25(OH)D₃ and the 25(OH)D₃ and 3-epi-25(OH)D₃ levels in umbilical venous blood were significantly lower in women with GDM (p?2, 25(OH)D₃, and total 25(OH)D were positively correlated with their levels in umbilical venous blood in the total, normal, and GDM groups.

Conclusions: The serum 25(OH)D₃ and 3-epi-25(OH)D₃ levels of babies from mothers with GDM are lower than in pregnant women without GDM.     

Screening of subclinical hypothyroidism during gestational diabetes in Pakistani population

Objective: The increased prevalence of adverse effects of altered thyroid functions in pregnancy inspired us to study the frequency of subclinical hypothyroidism (SCH) and the relationship with glycaemic control and foetal weight in pregnant females with and without gestational diabetes mellitus (GDM) in Pakistani population.

Patients and methods: Five hundred and eight pregnant females were enrolled and grouped as per the International Diabetes Association criteria into GDM (n?=?208) and healthy control (n?=?300). Random blood glucose (RBG), thyroid function tests, anthropometric analysis and foetal ultra sound scans were performed on all study subjects. Data were analysed using Mann–Whitney U test and Chi-square test wherever applicable. Spearman correlation and multiple regression analysis were performed. p values of <0.05 was considered significant.

Results: A total of 61.5% GDM subjects depicted SCH with normal circulating T4 and T3 versus 6.0% healthy controls (p-value <?0.001). Moreover, TSH remained independently associated with RBG (r?=?0.109; p?<?0.05), poor glycaemic control (r?=?0.227; p?<?0.001) and negatively associated with foetal growth (r?=??0.206; p?<?0.001).

Conclusion: The detection of high TSH with normal T3 and T4 in females with GDM strongly emphasises the need of thyroid screening as a routine in all antenatal clinics.