A study of serum growth differentiation factor 15 in Indian women with and without gestational diabetes mellitus in the
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ORIGINAL ARTICLE
A study of serum growth differentiation factor 15 in Indian women with and without gestational diabetes mellitus in the third trimester of pregnancy and its association with pro‑inflammatory markers and glucose metabolism Sudipta Banerjee1 · Rana Bhattacharjee1 · Amitabh Sur2 · Pieu Adhikary1 · Subhankar Chowdhury1 Received: 28 August 2020 / Accepted: 6 November 2020 © The Japan Diabetes Society 2020
Abstract The pathogenesis of gestational diabetes mellitus (GDM) is multifactorial and it shares many features with type 2 diabetes mellitus. Growth differentiation factor 15 (GDF-15), a member of transforming growth factor-β superfamily, is expressed in a high amount in the placenta in addition to other organs. This cross-sectional study was performed to assess the difference of GDF-15 and pro-inflammatory cytokines between pregnant women with or without GDM, and to explore the possible association of GDF-15 with the parameters of dysglycemia (Serum insulin, HOMA-IR, fasting, 60 min, and 120 min post75 gm oral glucose plasma glucose levels) and inflammation (IL-6 and TNF-α) in women with GDM at 24–28 weeks of gestation. Thirty-five women with GDM and 30 age-matched non-diabetic pregnant control (NDPC) subjects were recruited for the study. Mean serum GDF-15, IL-6, and TNF-α levels were significantly higher in GDM in comparison to the NDPC population. These differences persisted even after adjusting for the possible confounders like maternal age and BMI. GDF-15 level showed a positive correlation with parameters of dysglycemia (Serum insulin, HOMA-IR, fasting, 60 min, and 120 min post-75 gm oral glucose plasma glucose levels) but a variable correlation with the markers of inflammation. In conclusion, our study provides evidence that, in Indian women, serum GDF-15 level is higher in GDM in comparison to age-matched pregnant subjects without GDM in the early third trimester pregnancy. Moreover, in third trimester, GDF-15 level increases with increase in plasma glucose and insulin resistance. Keywords Diabetes · Gestational · Pregnancy · Growth differentiation factor 15 · Pro-inflammatory cytokines
Introduction * Rana Bhattacharjee [email protected] Sudipta Banerjee [email protected] Amitabh Sur [email protected] Pieu Adhikary [email protected] Subhankar Chowdhury [email protected] 1
Department of Endocrinology and Metabolism, IPGME&R and SSKM Hospital, 244 AJC Bose road, Kolkata, West Bengal, India
Department of Diabetology and Endocrinology, Peerless Hospital, Kolkata, West Bengal, India
2
Pregnancy is a physiological state of insulin resistance (IR). Gestational diabetes mellitus (GDM) is defined as diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation [1]. The prevalence of GDM in India varies between 3.8 and 22%. [2–5]. Uncontrolled gestational diabetes in pregnancy can lead to spontaneous abortion, preeclampsia, cesarean delivery, neonatal hypoglycemia, macrosomia, and fetal death. Not
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