Search Results (743)

Gestational diabetes mellitus (GDM) and iron deficiency anemia (IDA) are the most common pregnancy-related conditions resulting in adverse maternal and fetal complications. MicroRNAs (miRNAs), particularly miR-182-3p and miR-24-3p, are promising biomarkers as they act as regulatory elements in various diseases; however, their roles in GDM and IDA are unclear. The present study aimed to analyze the expression and functional relevance of miR-182-3p and miR-24-3p in GDM and IDA. Experimental validation via RT-PCR revealed significant upregulation of both miRNAs in GDM and IDA samples. We identified common target genes and signaling pathways associated with these miRNAs, using a combination of data mining, bioinformatic tools (miRDB, TargetScan, miRTarBase, and miRWalk), and differentially expressed gene (DEGs) analysis using the GEO, OMIM, MalaCards, and GeneCards datasets. GO and KEGG pathway analyses revealed that the shared miRNA–mRNA in target genes were enriched in insulin signaling, apoptosis, and inflammatory pathways—key mechanisms implicated in GDM and IDA. Furthermore, hub genes such as IRS1, PIK3CA, CASP3, MAPK7, and PDGFRB were identified, supporting their central role in metabolic dysregulation during pregnancy. These findings demonstrate the potential of miR-182-3p and miR-24-3p as diagnostic biomarkers and therapeutic targets in managing GDM and IDA, offering new insights into the molecular interplay underlying pregnancy complications. Full article

Objectives: The objective of this study was to investigate the relationship between the simultaneous 75 g Oral glucose tolerance test (OGTT), gestational diabetes mellitus (GDM), and fetal pancreatic circumference at 24–28 weeks of gestation. Methods: This prospective case–control study was conducted between September 2024 and February 2025 at our perinatology clinic, which provides tertiary health care services. The correlation between the 75 g OGTT, GDM, and pancreatic circumference was assessed by comparing fetal pancreatic circumference between the groups with and without GDM at the time of diagnosis. Results: A total of 130 pregnant patients were recruited for this` study, with 64 patients forming the GDM group and 66 patients forming the control group. Fetal pancreas circumference (7.0 cm vs. 6.4 cm, p < 0.001), fetal pancreas circumference percentile (88.5 vs. 52, p < 0.001), and the rate of fetal pancreas size >90th percentile (15.6% vs. 3%, p < 0.001) were significantly higher in the GDM group compared to the control group. Conclusions: Although our findings demonstrate a statistically significant correlation between fetal pancreatic circumference and GDM, diagnostic performance remains modest. Therefore, fetal pancreatic circumference should be interpreted as a supportive marker, such as family history, rather than a definitive marker for identifying individuals at risk for GDM. Full article

Background/Objectives: SIRT1 is a NAD⁺-dependent protein deacetylase regulating metabolic and stress response pathways. Genetic variations in the SIRT1 gene may contribute to the pathogenesis of type 2 diabetes mellitus (T2DM). This case–control study investigates the associations of two SIRT1 promoter polymorphisms, rs12778366 and rs3758391, in patients with type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM), preeclampsia, and healthy controls. Methods: This case–control study compared the genotypes between T2DM and pregnant and non-pregnant controls. We also compared genotypes between pregnant women with T2DM, GDM, preeclampsia, and healthy pregnant controls. Genomic DNA was extracted and analyzed using PCR-RFLP for the detection of rs12778366 and rs3758391 polymorphisms. Genotype frequencies were compared using chi-square tests, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: The study included 66 patients with T2DM, 36 with GDM, 12 with preeclampsia, and 81 pregnant and non-pregnant controls (33 pregnant controls). Although rs3758391 was more frequent in T2DM, the difference was not statistically significant between SIRT1 polymorphisms and T2DM. The CT genotype was more prevalent in T2DM (54.5%) compared to controls (33.4%); however, this difference was not significant. We finally found no significant association of the investigated SIRT1 polymorphisms with any of the conditions studied. In addition, the small sample size, especially for preeclampsia cases, limits the statistical power to detect significant associations. Conclusions: Although no significant association was observed between SIRT1 polymorphisms and diabetes, the findings of our study underscore the need for further studies examining SIRT1 polymorphisms in various ethnic groups, with a focus on leveraging these genetic variations in diabetes pathophysiology. Larger studies in the Greek population could also provide additional meaningful findings. Full article

Background: Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication globally. Maternal vitamin D deficiency has been linked to the risk of GDM. The aim of this study was to explore and synthesise current evidence on the association between vitamin D deficiency and the development of gestational diabetes in Western countries. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodological framework. Relevant studies were identified through a comprehensive search across seven databases: ProQuest Public Health, Google Scholar, PubMed, ScienceDirect, The Lancet, BMC Public Health, the International Journal of Women’s Health, and Scopus. Studies were included based on predefined inclusion and exclusion criteria relevant to the research question. The review followed the JBI protocol, and the PRISMA flowchart was used to guide and visualise the study selection process. Results: Nineteen studies were included in the final analysis, comprising research predominantly from Australia (5), the United States (5), and Canada (4). The findings indicate a notable association between vitamin D deficiency and GDM risk, moderated by factors such as maternal age, ethnicity, seasonal variation, and body mass index (BMI). Older maternal age and higher BMI were linked with lower vitamin D levels and a higher incidence of GDM. Ethnic groups with darker skin tones showed higher rates of vitamin D deficiency, increasing vulnerability to GDM. Seasonal patterns revealed lower vitamin D levels during winter months, correlating with greater GDM risk. These patterns underscore the need for targeted preventive strategies, including the potential role of vitamin D supplementation. Conclusions: This review supports an observed association between maternal vitamin D deficiency and increased GDM risk, influenced by demographic and environmental factors. While the evidence points to a potential preventative role for vitamin D, further high-quality research, including systematic reviews and meta-analyses, is essential to establish causality and inform clinical guidelines. The review identifies knowledge gaps and suggests directions for future research and clinical practice. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) is a common metabolic disorder in pregnant women. It can lead to several complications, such as preterm delivery, macrosomia, or metabolic disorders in newborns. Studies have revealed morphological and transcriptional differences between the placentas of patients with GDM and women with normal glucose tolerance. Sirtuins (SIRTs) are nicotinamide adenine dinucleotide-dependent deacetylases that interact with and regulate the activity of numerous proteins. However, little is known about their role in the pathogenesis of GDM. This study was performed to analyze the placental expression of SIRTs and investigate their correlations with clinical parameters. Methods: GDM was diagnosed based on the 75 g oral glucose tolerance test in accordance with the criteria developed by the International Association of Diabetes and Pregnancy Study Groups. Placental tissues were collected, and the expression of SIRT1,-3,-4 and a reference gene (β-2 microglobulin) was analyzed. Results: The placental expression of SIRT1 and SIRT3 was elevated in women with GDM. However, there was no significant difference in SIRT4 expression between women with GDM and those with normal glucose tolerance. Furthermore, we found no significant correlations between SIRT1, SIRT3, and SIRT4 expression and clinical parameters. Conclusions: The findings of this study demonstrate elevated expression of SIRT1 and SIRT3 in the placentas of women with GDM. Further studies are required to confirm our observations and demonstrate the precise role of these enzymes in GDM. Full article

Background/Objectives: To assess the association between early pregnancy carbohydrate quality, as measured by the Carbohydrate Quality Index (CQI), and the risk of delivering a large-for-gestational-age (LGA) infant in a Mediterranean pregnant cohort of northern Greece. Methods: We analyzed singleton pregnancies from the BORN 2020 prospective cohort in Greece. Dietary intake was assessed via a validated food frequency questionnaire, and CQI was computed from glycemic index, fiber density, whole-to-refined grain ratio, and solid-to-liquid carbohydrate ratio. Multivariable logistic regression was used to estimate the association between CQI (in tertiles) and LGA risk, defined as birthweight >90th percentile. Results: Among the 797 participants, 152 (19.1%) delivered LGA infants, and 117 (14.7%) were diagnosed with GDM. Of those with GDM, 23 (19.7%) delivered LGA infants. In the total population, higher maternal weight (p < 0.001), height (p = 0.006), and pre-pregnancy BMI (p = 0.004) were significantly associated with LGA. A greater proportion of women with LGA had a BMI > 25 (p = 0.007). In the GDM subgroup, maternal height remained significantly higher in those who delivered LGA infants (p = 0.017). In multivariable models, moderate CQI was consistently associated with increased odds of LGA across all models (Model 1: aOR = 1.60 (95% CI: 1.03–2.50), p = 0.037, Model 2: aOR = 1.57 (95% CI: 1.01–2.46), p = 0.046, Model 3: aOR = 1.58 (95% CI: 1.01–2.47), p = 0.044, Model 4 aOR: 1.70; 95% CI: 1.08–2.72; p = 0.023), whereas high CQI was not. In the GDM subgroup, a significant association between high CQI and increased LGA risk was observed in less adjusted models (Model 1 aOR: 6.74; 95% CI: 1.32–56.66; p = 0.039, Model 2 aOR: 6.64; 95% CI: 1.27–57.48; p = 0.044), but this was attenuated and became non-significant in the fully adjusted model (aOR: 3.05; 95% CI: 0.47–30.22; p = 0.28). When examining CQI components individually, no consistent associations were observed. Notably, a higher intake of low-quality carbohydrates (≥50% of energy intake) was significantly associated with increased LGA risk in the total population (aOR: 4.25; 95% CI: 1.53–11.67; p = 0.005). Conclusions: Higher early pregnancy intake of low-quality carbohydrates was associated with an elevated risk of LGA in the general population. However, CQI itself showed a non-linear and inconsistent relationship with LGA, with moderate, but not high, CQI linked to increased risk, particularly in GDM pregnancies, where associations were lost after adjustment. Both carbohydrate quality and quantity evaluations are essential, particularly in high-risk groups, to inform dietary guidance in pregnancy. Full article

Background: Gestational diabetes mellitus (GDM) affects 7–9% of pregnancies worldwide and is associated with adverse maternal and neonatal outcomes. Nutritional therapy is a key component of GDM management. However, inconsistencies exist across international and national guidelines regarding macronutrient distribution, glycemic targets, and micronutrient supplementation. This systematic review aims to compare updated nutritional recommendations for GDM across major health organizations and identify areas of consensus, divergence, and evidence gaps. Methods: This systematic review was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251026194). A comprehensive literature search was performed in PubMed, Scopus, and Google Scholar (concluding March 2025), along with manual searches of official websites of professional health organizations (e.g., ADA, WHO, NICE, IDF). Guidelines published within the last 10 years (or the most relevant national guideline if slightly older), available in English or with access to translation, and including explicit nutritional recommendations for GDM were included. Data were extracted on macronutrient composition, glycemic targets, and micronutrient supplementation, with evaluation of the supporting evidence and regional context, incorporating findings from recent key guideline updates. Results: In total, 12 guidelines met the inclusion criteria. While all guidelines emphasized carbohydrate moderation and adequate fiber intake, significant discrepancies were found in carbohydrate quality recommendations (e.g., low-glycemic index focus vs. total carbohydrate restriction), postprandial glucose targets (e.g., 1-h vs. 2-h measurements and varying thresholds like <120 vs. <140 mg/dL), and the use of non-routine micronutrients such as chromium, selenium, and omega-3 fatty acids (generally lacking endorsement). Recent updates from key bodies like ADA, Diabetes Canada, and KDA largely maintain these core stances but show increasing emphasis on dietary patterns and acknowledgement of CGM technology, without resolving key discrepancies. Cultural adaptability and behavioral counselling strategies were minimally addressed across most guidelines. Conclusions: Despite general agreement on the principal recommendations of nutritional management in GDM, substantial variation persists in specific recommendations, even considering recent updates. Consistent, evidence-based, and culturally adaptable guidelines incorporating implementation strategies are needed to optimize care and reduce disparities in GDM management across regions. Full article

Background and Objectives: Gestational diabetes mellitus (GDM) is a major public health concern associated with adverse maternal and neonatal outcomes. It was found that even physiological pregnancy is followed by a significant shift in serum lipid profile, and even more pronounced in GDM pregnancies. We aimed to comprehensively assess lipid parameters among pregnant women with and without GDM. Materials and Methods: A systematic review, covering PubMed, WoS, and SCOPUS until 23 July 2024, with meta-analysis and meta-regression, was conducted, comprising studies measuring TG, TC, LDL-C, HDL-C, VLDL-C, and TG/HDL ratio in pregnant women diagnosed with GDM, and those with normal glucose tolerance. The overall effect size measure was the SMD. NOS and JADAD scales were used for quality assessment, I² statistics for heterogeneity evaluation, and funnel plots for publication bias inspection. Results: A total of 457 studies were included in the qualitative analysis, and 74, 277, and 122 studies were included in the quantitative analysis for the 1st 2nd, and 3rd trimester, respectively. TG and TG/HDL levels were significantly elevated in all three trimesters (TG: SMD = 0.61, 0.57, and 0.48, p < 0.001 for all, and TG/HDL: SMD = 0.44, 0.66, and 0.49; p < 0.001 for all), while TC and LDL-C levels showed significant increases in the 1st and 2nd trimesters (TC: SMD = 0.38, 0.27, p < 0.001 for both, LDL-C: SMD = 0.33, 0.20, p < 0.001 for both), in pregnant women with GDM compared to those without the condition. Conclusions: GDM is associated with significant lipid abnormalities, particularly elevated TG and decreased HDL-C levels. These lipid changes are most pronounced in the first and second trimesters, highlighting the importance of early detection and management. Full article

Background/Objectives: To evaluate diabetes risk perception in women with prior gestational diabetes mellitus (GDM) and prediabetes in early postpartum. Methods: Secondary analysis of a multi-center randomized controlled trial assessing the effectiveness of a mobile-based postpartum lifestyle intervention in women with prediabetes after GDM. Data were collected from the Risk Perception Survey for Developing Diabetes at baseline (6–16 weeks postpartum) and one year post-randomization. Logistic regression was used to analyze the difference between the intervention and control groups on diabetes risk estimation. Results: Among 165 women with prediabetes in early postpartum (mean age: 32.1 years, mean BMI: 27.3 kg/m²), 58.9% (96) adequately estimated their diabetes risk (moderate or high chance) at baseline. These women smoked less often [2.06% (2) vs. 10.3% (7), p = 0.034], reported less anxiety (11.6 ± 3.0 vs. 12.6 ± 3.5, p = 0.040), and reported fewer symptoms of depression [30.9% (21) vs. 15.6% (15), p = 0.023] compared to women who underestimated their risk. At one year, 58.3% (95) of all women adequately estimated their diabetes risk. In the intervention group, 50.6% (41) adequately estimated their risk at baseline, increasing to 56.8% (46) by the end of the intervention after one year (p = 0.638). In the control group, a higher proportion of women adequately estimated their risk at baseline [67.1% (55), (p = 0.039)], which decreased to 59.8% (49) at one year (p = 0.376), with no significant difference in risk perception between the groups at one year (p = 0.638). Conclusions: Almost 60% of this high-risk population adequately estimated their diabetes risk, with no significant impact of the lifestyle intervention on risk perception. Full article

Background/Objectives: Pregnancies complicated by idiopathic polyhydramnios are linked to a heightened risk of numerous maternal and perinatal complications. We aim to study the implications of polyhydramnios in term pregnancies complicated with gestational diabetes mellitus (GDM). Methods: A prospective cohort study including 340 GDM cases was conducted. An ultrasound scan was conducted at term between 37 and 40 weeks and amniotic fluid volume (AFV) was assessed by measuring the amniotic fluid index (AFI) and the single deepest pocket (SDP). Maternal demographics and obstetric and perinatal outcomes were evaluated after delivery. We performed comparisons between groups with normal AFV and polyhydramnios (AFI ≥ 24 cm or SDP ≥ 8 cm), and between groups with normal and increased AFV (AFI or SDP ≥ 75th centile). A multivariate logistic regression analysis was performed to study association between AVF measurements and adverse maternal and perinatal outcomes. Results: We found that women with GDM and polyhydramnios at term had a higher risk of maternal (54.3 vs. 27.5%, p < 0.001) and perinatal adverse outcomes (65.7% vs. 46.5%, p < 0.03). The increased AFV group showed a higher risk of fetal overgrowth (LGA: 21.4% vs. 8.2%, p < 0.001 and macrosomia: 19.8% vs. 5.4%, p < 0.001, respectively) and a lesser risk of delivering an SGA fetus (6.3% vs. 13.6%, respectively). Both AFI and SDP showed a significant correlation with newborn weight (r = 0.27; p < 0.001 and r = 0.28; p < 0.001, respectively) and newborn centile (r = 0.26; p < 0.001 and r = 0.26 for both). Subsequent to conducting a multivariate logistic regression analysis adjusted for pregestational BMI, nulliparity, and insulin treatment, both AFI and SDP were significantly associated with perinatal complications, but AFI showed a stronger association with fetal overgrowth (aOR 1.11; p = 0.004 for a LGA fetus and aOR 1.12; p = 0.002 for macrosomia) and with lower risk of delivering an SGA fetus (aOR 0.89; p = 0.009) or IUGR fetus (aOR 0.86; p = 0.03). ROC analysis showed a poor diagnostic performance of both AFI and SDP for identifying macrosomia (AUC 0.68 for AFI, and 0.65 for SDP). Conclusions: Detection of polyhydramnios at term, whether using AFI or SDP, identifies a subgroup of women with gestational diabetes with higher risks of obstetric and perinatal complications. Cases with increased AFV (AFI ≥ 18 cm or SDP ≥ 6.5 cm) are also associated with an increased risk of fetal overgrowth and may require more intensive monitoring for management and optimal delivery timing, with the aim of improve perinatal outcomes. Full article

Chemerin is an adipokine that is associated with insulin resistance, a feature well marked in gestational diabetes mellitus (GDM). Recent publications and meta-analyses investigating chemerin levels in GDM remain inconclusive. This updated systematic review and meta-analysis aims to update the current evidence of an association between chemerin and GDM. The databases PubMed, ScienceDirect, and Google Scholar were searched for eligible articles from their inception up to 1 April 2025. Pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs) of the chemerin levels between GDM cases and normoglycemic controls were calculated using the “meta” package in “R” software. Twenty-two studies were included in this meta-analysis, comprising a total of 1735 GDM cases and 1701 normoglycemic pregnant controls. Due to significant heterogeneity, a random effects model was applied, and the chemerin levels were found to be significantly higher in cases compared to normoglycemic controls [SMD = 0.97, 95% CI (0.16; 1.78) ng/mL; p = 0.020]. Subgroup analysis showed that studies conducted in Asia, studies utilizing a case–control design, patients younger than 30 years, and patients with a BMI less than 28 showed significantly higher chemerin levels in cases compared to controls. Meta-regression analysis indicated that only patients over 30 years old showed a negative association with chemerin levels. No evidence of publication bias was observed. This updated meta-analysis confirmed that chemerin levels are elevated in cases of GDM, which may indicate its involvement in the pathogenesis of GDM. Further longitudinal studies are needed to consolidate this finding. Full article

Diabetes mellitus (DM), a chronic metabolic disease, poses a significant challenge to global health. Although type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM), and other types of diabetes mellitus differ in pathological mechanisms, they converge in that hyperglycemia is a universal clinical hallmark. Currently, the antidiabetic medications employed in clinical practice for blood glucose management require long-term administration and are associated with various side effects that can adversely impact human health. Plant heteropolysaccharides have emerged as promising candidates for anti-diabetic therapy, owing to their abundant natural sources, absence of toxicities, and confirmed hypoglycemic activities. This review aims to summarize the anti-diabetic mechanisms of plant heteropolysaccharides by dissecting the key biological pathways associated with clinical intervention in DM, including the modulation of insulin secretion, a reduction in insulin resistance, and an alteration in the composition of the gut microbiota. For these reasons, these findings provide a theoretical framework for the clinical application of plant heteropolysaccharides and indicate that they are expected to become natural agents used in treating DM. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) represents an increased metabolic risk in future life for both mother and child. We hypothesize free fatty acids (FFAs) and amino acids (AAs) disturbances in plasma during second trimester might be indicating high risk of persisting glucose intolerance (PGI). The aim of study was to determine plasma FFAs and AAs during pregnancy in women with normal pregnancy and GDM and also in post-GDM women with PGI after delivery and to find potential association of altered FFAs and AAs profile with adverse peripartal outcomes and PGI after GDM. Material and Methods: A total of 54 pregnant women were included in the study. Of those 34 participants had GDM. PGI was diagnosed by oGTT up to one year after delivery. Plasma FFAs were determined using GC-FID and plasma AAs levels were determined using CE-MS method. Results: Decreased levels of tetradecanoic acid and several AAs were found in GDM group during pregnancy. Oleic and docosahexaenoic acid correlated positively while almost all AAs negatively correlated with oGTT values in the pregnancy (all p < 0.05, Spearman). Logistic regression model (using AAs, FFAs and BMI) identified higher citrulline and glutamate levels and lower tetradecenoic acid and choline as the best predictors for postpartum PGI. Some differences in AA levels were detected in women with macrosomic babies. Conclusions: Data support a possible link between GDM development and PGI after delivery and selected metabolite levels. The predictive potential of plasma FFAs and AAs levels on a diabetes risk in future life requires further validation. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) is a common metabolic disorder during pregnancy, associated with increased risks for both maternal and fetal complications. Insulin resistance plays a central role in its pathophysiology. This study aimed to evaluate the predictive value of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in diagnosing GDM and to explore its correlation with clinical and anthropometric parameters in a Romanian population. Methods: A retrospective case–control study was conducted on 320 pregnant women between 24 and 28 weeks of gestation. Based on ADA criteria, participants were divided into 160 with GDM and 160 controls, matched by age and gestational week. Fasting glucose, insulin, BMI, and blood pressure were assessed. HOMA-IR and HOMA-β were calculated. Statistical analyses included t-tests, Pearson correlation, and logistic regression. Results: HOMA-IR was significantly higher in the GDM group (2.9 vs. 1.8; p < 0.001). It correlated with fasting insulin (r = 0.85, p < 0.001), fasting glucose (r = 0.65, p < 0.001), BMI (r = 0.60, p < 0.001), and systolic blood pressure (r = 0.42, p < 0.001). Logistic regression identified HOMA-IR as an independent predictor of GDM (OR = 2.4, 95% CI: 1.6–3.5, p < 0.001), along with BMI (p = 0.01) and maternal age (p = 0.05). Conclusions: HOMA-IR is significantly associated with GDM and may enhance mid-gestational risk assessment when combined with clinical and anthropometric measures. Further studies are needed to validate its predictive accuracy in broader populations. Full article

Gestational diabetes mellitus (GDM) occurs in approximately 9–25% of pregnancies and, if left undiagnosed or inadequately controlled, can lead to adverse outcomes for both the mother and the fetus, short and long term. GDM is characterized by glucose intolerance with onset or first recognition during pregnancy and is a multifactorial condition with a pathophysiology that remains incompletely understood. It is strongly associated with a chronic low-grade inflammatory state that contributes to insulin resistance, a hallmark of GDM pathogenesis. Among the fundamental pro-inflammatory cytokines implicated in this process, TNF-α and IL-6 play central roles. TNF-α is a cytokine primarily secreted by activated macrophages, as well as by adipocytes in the context of obesity. Many studies have shown that its levels are elevated in pregnant women with GDM compared to normoglycemic pregnant individuals. IL-6 is another pro-inflammatory cytokine secreted by immune cells, adipose tissue, and the placenta. It is found in higher concentrations in the maternal circulation during pregnancies complicated by GDM. Both TNF-α and IL-6 act synergistically to perpetuate a pro-inflammatory intrauterine environment. Their combined effects exacerbate insulin resistance and may impair pancreatic β-cell compensation during pregnancy, facilitating the onset of GDM in genetically or metabolically susceptible individuals. Recent research has identified various maternal serum biomarkers, such as TNF-α and IL-6, that may hold promise for the early detection of GDM. The aim of our study is to evaluate whether TNF-α and IL-6 can be used as diagnostic tools for the early diagnosis of GDM, allowing for timely intervention and reducing the risk of associated maternal and fetal complications. Full article