Lois Sara James, (2022) Is there a Link between Iron related Parameters and Insulin Resistance in Gestational Diabetes Mellitus? Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION: Gestational diabetes mellitus (GDM) is a major health problem worldwide. Insulin resistance is a major feature of diabetes mellitus as well as a cause of GDM. Associations have been reported between increased body iron stores and insulin resistance. Serum levels of ferritin (a marker of body iron stores) and hepcidin (the central regulator of systemic iron homeostasis) have been reported to be elevated in women with GDM. Such elevations have been reported to be a significant risk factor for GDM. However, it is not clear how exactly these are linked to development of GDM. AIM OF THE STUDY: The aim of this study was to estimate iron-related parameters in blood and insulin resistance in women with GDM, and to determine if they are associated. OBJECTIVES: 1. To estimate iron-related parameters in blood from pregnant women, with and without GDM. 2. To estimate fasting blood glucose and insulin levels in pregnant women, with and without GDM. 3. To calculate indices of insulin resistance in pregnant women, with and without GDM. 4. To determine if any correlation exists between iron-related parameters in blood and indices of insulin resistance in pregnant women, with and without GDM. MATERIAL AND METHODS: The study was carried out in the antenatal clinic of the Community Health and Development (CHAD) hospital of Christian Medical College, Vellore, Tamil Nadu, India. Primigravidae who were referred for an oral glucose tolerance test (OGTT) were recruited, after obtaining informed consent. A fasting blood sample was obtained from each woman and used to estimate levels of glucose, insulin, ferritin, iron, total iron-binding capacity (TIBC) and C- reactive protein (CRP). RESULTS: One hundred and fifty-five primigravidae were screened. Twenty-five were found to have GDM. From among those screened, 25 age-matched (chronological and gestational ages) control subjects were chosen from among those who did not have GDM. Maternal age, gestational age at the time of recruitment, gestational age at delivery and birth weight of babies were similar in both groups. Levels of glucose in blood and insulin resistance (as assessed by HOMA-IR) were higher in those with GDM. Levels of haemoglobin and iron-related parameters were similar in the 2 groups. Iron-related parameters correlated with one another, in keeping with known biological relationships. Parameters linked to glucose and insulin were also significantly associated with one another, in keeping with known relationships. Iron-related parameters and indices of insulin resistance did not show any significant association with one another. CONCLUSIONS: In this study, no significant association was found between iron-related parameters in blood and insulin resistance. However, the sample size in this study was small. An adequate number of subjects would need to be studied to confirm these observations.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201823202 |
| Uncontrolled Keywords: | Gestational diabetes mellitus, insulin resistance, iron, ferritin, pregnancy |
| Subjects: | MEDICAL > Biochemistry > MEDICAL > Biochemistry |
| Depositing User: | Subramani R |
| Date Deposited: | 17 May 2021 17:14 |
| Last Modified: | 03 Mar 2024 04:54 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/17001 |
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