Top

Published in:

27-11-2022 | Insulins | Maternal-fetal Medicine

Fetal pancreas size and maternal serum biomarkers glycated albumin and insulin-regulated aminopeptidase provide no potential for early prediction of gestational diabetes mellitus

Authors: Filiz Yarsilikal Guleroglu, Aliye Balkan Ozmen, Isil Turan Bakirci, Sevilay Yavuz Dogu, Ibrahim Yılmaz, Ali Cetin

Published in: Archives of Gynecology and Obstetrics | Issue 5/2023

Abstract

Purpose

We aimed to determine the predictive values of fetal pancreas size and maternal serum biomarkers glycated albumin (GA) and insulin-regulated aminopeptidase (IRAP) for gestational diabetes mellitus (GDM).

Materials and methods

In this prospective observational study including 109 pregnant women, the fetal pancreas size and maternal serum biomarkers GA and IRAP were measured at the gestational age of 20–22 weeks and later at the gestational age of 24–28 weeks, in 19 participants of them, GDM was confirmed with the 75-g oral glucose tolerance test (OGTT) and the fetal pancreas size was measured in all the participants again.

Results

The median fetal pancreas sizes were significantly higher in women with or without GDM when measured at the 24–28 weeks of pregnancy compared to those at the 20–22 weeks of pregnancy (p < 0.05). At both of the 20–22 and 24–28 weeks of pregnancy, the median values of fetal pancreas sizes in the women with or without GDM were found comparable (p > 0.05). There were no significant differences between pregnant women with or without GDM regarding maternal serum biomarkers GA and IRAP (p > 0.05). Multivariate logistic regression analysis revealed no meaningful association of study parameters with the development of GDM.

Conclusion

The fetal pancreas size and maternal serum biomarkers GA and IRAP provide no potential for early prediction of GDM at the 20–22 weeks of gestation. Further studies, including serial measurement of these parameters during the second and third trimesters of GDM pregnancies, may clarify their role in the antenatal care of women with GDM.

Clinical trials

NCT05392231.

Man B, Schwartz A, Pugach O, Xia Y, Gerber B (2021) A clinical diabetes risk prediction model for prediabetic women with prior gestational diabetes. PLoS One 16:e0252501–e0252501. https://doi.org/10.1371/journal.pone.0252501CrossRefPubMedPubMedCentral

Shou C, Wei Y-M, Wang C, Yang H-X (2019) Updates in long-term maternal and fetal adverse effects of gestational diabetes mellitus. Matern Fetal Med 1:91–94 CrossRef

Tam WH, Ma RCW, Ozaki R, Li AM, Chan MHM, Yuen LY et al (2017) In utero exposure to maternal hyperglycemia increases childhood cardiometabolic risk in offspring. Diabetes Care 40:679–686. https://doi.org/10.2337/dc16-2397CrossRefPubMedPubMedCentral

Wu Y-T, Zhang C-J, Mol BW, Kawai A, Li C, Chen L et al (2021) Early prediction of gestational diabetes mellitus in the Chinese population via advanced machine learning. J Clin Endocrinol Metab 106:e1191–e1205. https://doi.org/10.1210/clinem/dgaa899CrossRefPubMed

Salmeri N, Villanacci R, Ottolina J, Bartiromo L, Cavoretto P, Dolci C et al (2020) Maternal arsenic exposure and gestational diabetes: a systematic review and meta-analysis. Nutrients. https://doi.org/10.3390/nu12103094CrossRefPubMedPubMedCentral

Eskenazi B, Rauch S, Iurlaro E, Gunier RB, Rego A, Gravett MG et al (2022) Diabetes mellitus, maternal adiposity, and insulin-dependent gestational diabetes are associated with COVID-19 in pregnancy: the INTERCOVID study. Am J Obstet Gynecol 227:74.e1-74.e16. https://doi.org/10.1016/j.ajog.2021.12.032CrossRefPubMed

Yoles I, Sheiner E, Wainstock T (2021) First pregnancy risk factors and future gestational diabetes mellitus. Arch Gynecol Obstet 304:929–934. https://doi.org/10.1007/s00404-021-06024-8CrossRefPubMed

Grieger JA, Leemaqz SY, Knight EJ, Grzeskowiak LE, McCowan LM, Dekker GA et al (2022) Relative importance of metabolic syndrome components for developing gestational diabetes. Arch Gynecol Obstet 305:995–1002. https://doi.org/10.1007/s00404-021-06279-1CrossRefPubMed

Sirico A, Rossi ED, Degennaro VA, Arena V, Rizzi A, Tartaglione L et al (2022) Placental diabesity: placental VEGF and CD31 expression according to pregestational BMI and gestational weight gain in women with gestational diabetes. Arch Gynecol Obstet. https://doi.org/10.1007/s00404-022-06673-3CrossRefPubMed

10.

Leong I (2018) ANGPTL8 as an early predictor of gestational diabetes mellitus. Nat Rev Endocrinol 14:64. https://doi.org/10.1038/nrendo.2017.167CrossRefPubMed

11.

Ning H, Tao H, Weng Z, Zhao X (2016) Plasma fatty acid-binding protein 4 (FABP4) as a novel biomarker to predict gestational diabetes mellitus. Acta Diabetol 53:891–898. https://doi.org/10.1007/s00592-016-0867-8CrossRefPubMed

12.

Madhu SV, Bhardwaj S, Jhamb R, Srivastava H, Sharma S, Raizada N (2019) Prediction of gestational diabetes from first trimester serum adiponectin levels in indian women. Indian J Endocrinol Metab 23:536–539. https://doi.org/10.4103/ijem.IJEM_319_19CrossRefPubMedPubMedCentral

13.

Sweeting AN, Wong J, Appelblom H, Ross GP, Kouru H, Williams PF et al (2019) A novel early pregnancy risk prediction model for gestational diabetes mellitus. Fetal Diagn Ther 45:76–84. https://doi.org/10.1159/000486853CrossRefPubMed

14.

Kansu-Celik H, Ozgu-Erdinc AS, Kisa B, Findik RB, Yilmaz C, Tasci Y (2019) Prediction of gestational diabetes mellitus in the first trimester: comparison of maternal fetuin-A, N-terminal proatrial natriuretic peptide, high-sensitivity C-reactive protein, and fasting glucose levels. Arch Endocrinol Metab 63:121–127. https://doi.org/10.20945/2359-3997000000126CrossRefPubMed

15.

Hattan RA, Rees GK, Johnson ML (1982) Normal fetal anatomy. Radiol Clin North Am 20:271–284PubMed

16.

Cyr DR (1983) Ultrasonic visualization of the fetal pancreas and hepatic venous circulation. Med Ultrasound 7:27–31

17.

Hill LM, Peterson C, Rivello D, Hixson J, Belfar HL (1989) Sonographic detection of the fetal pancreas. J Clin Ultrasound 17:475–479. https://doi.org/10.1002/jcu.1870170704CrossRefPubMed

18.

Hata K, Hata T, Kitao M (1988) Ultrasonographic identification and measurement of the human fetal pancreas in utero. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 26:61–64. https://doi.org/10.1016/0020-7292(88)90197-xCrossRef

19.

Kivilevitch Z, Achiron R, Perlman S, Gilboa Y (2017) The Normal Fetal Pancreas. J Ultrasound Med Off J Am Inst Ultrasound Med 36:1997–2005. https://doi.org/10.1002/jum.14233CrossRef

20.

Akkaya H, Büke B, Uysal G (2020) Fetal pancreatic hyperechogenicity may be an early ultrasonographic sign of gestational diabetes mellitus. J Matern Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet 33:2387–2394. https://doi.org/10.1080/14767058.2018.1551351CrossRef

21.

Gilboa Y, Krekora M, Perlman S, Bardin R, Kassif E, Achiron R et al (2022) Sonographic measurement of the fetal pancreas in women with gestational diabetes. Arch Med Sci 18:382–387. https://doi.org/10.5114/aoms/140578CrossRefPubMed

22.

Nombo AP, Mwanri AW, Brouwer-Brolsma EM, Ramaiya KL, Feskens EJM (2018) Gestational diabetes mellitus risk score: a practical tool to predict gestational diabetes mellitus risk in Tanzania. Diabetes Res Clin Pract 145:130–137. https://doi.org/10.1016/j.diabres.2018.05.001CrossRefPubMed

23.

Coustan DR, Lowe LP, Metzger BE, Dyer AR (2010) The hyperglycemia and adverse pregnancy outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. Am J Obstet Gynecol 202(654):e1-6. https://doi.org/10.1016/j.ajog.2010.04.006CrossRef

24.

Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC et al (2015) The international federation of gynecology and obstetrics (FIGO) initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care#. Int J Gynecol Obstet 131:S173–S211. https://doi.org/10.1016/S0020-7292(15)30033-3CrossRef

25.

Chatzakis C, Cavoretto P, Sotiriadis A (2021) Gestational diabetes mellitus pharmacological prevention and treatment. Curr Pharm Des 27:3833–3840. https://doi.org/10.2174/1381612827666210125155428CrossRefPubMed

26.

Syngelaki A, Pastides A, Kotecha R, Wright A, Akolekar R, Nicolaides KH (2015) First-trimester screening for gestational diabetes mellitus based on maternal characteristics and history. Fetal Diagn Ther 38:14–21. https://doi.org/10.1159/000369970CrossRefPubMed

27.

Sirico A, Lanzone A, Mappa I, Sarno L, Słodki M, Pitocco D et al (2019) The role of first trimester fetal heart rate in the prediction of gestational diabetes: a multicenter study. Eur J Obstet Gynecol Reprod Biol 243:158–161. https://doi.org/10.1016/j.ejogrb.2019.10.019CrossRefPubMed

28.

Sirico A, Sarno L, Zullo F, Martinelli P, Maruotti GM (2019) Pregestational diabetes and fetal heart rate in the first trimester of pregnancy. Eur J Obstet Gynecol Reprod Biol 232:30–32. https://doi.org/10.1016/j.ejogrb.2018.11.003CrossRefPubMed

29.

Xi F, Chen H, Chen Q, Chen D, Chen Y, Sagnelli M et al (2021) Second-trimester and third-trimester maternal lipid profiles significantly correlated to LGA and macrosomia. Arch Gynecol Obstet 304:885–894. https://doi.org/10.1007/s00404-021-06010-0CrossRefPubMed

30.

UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet (London, England) 352:837–853CrossRef

31.

Cavagnolli G, Pimentel AL, Freitas PAC, Gross JL, Camargo JL (2015) Factors affecting A1C in non-diabetic individuals: review and meta-analysis. Clin Chim Acta 445:107–114. https://doi.org/10.1016/j.cca.2015.03.024CrossRefPubMed

32.

Freitas PAC, Ehlert LR, Camargo JL (2017) Glycated albumin: a potential biomarker in diabetes. Arch Endocrinol Metab 61:296–304. https://doi.org/10.1590/2359-3997000000272CrossRefPubMed

33.

Kohzuma T, Tao X, Koga M (2021) Glycated albumin as biomarker: evidence and its outcomes. J Diabetes Complic 35:108040. https://doi.org/10.1016/j.jdiacomp.2021.108040CrossRef

34.

Zhu J, Chen Y, Li C, Tao M, Teng Y (2018) The diagnostic value of glycated albumin in gestational diabetes mellitus. J Endocrinol Invest 41:121–128. https://doi.org/10.1007/s40618-016-0605-7CrossRefPubMed

35.

Chume FC, Renz PB, Hernandez MK, Freitas PAC, Camargo JL (2021) Is there a role for glycated albumin in the diagnosis of gestational diabetes mellitus? Endocrine 72:681–687. https://doi.org/10.1007/s12020-021-02673-6CrossRefPubMed

36.

Keller SR (2004) Role of the insulin-regulated aminopeptidase IRAP in insulin action and diabetes. Biol Pharm Bull 27:761–764. https://doi.org/10.1248/bpb.27.761CrossRefPubMed

37.

Krskova K, Balazova L, Dobrocsyova V, Olszanecki R, Suski M, Chai SY et al (2020) Insulin-regulated aminopeptidase inhibition ameliorates metabolism in obese zucker rats. Front Mol Biosci 7:586225CrossRefPubMedPubMedCentral

38.

Mostafa TM, El-Gharbawy NM, Werida RH (2021) Circulating IRAPe, Irisin, and IL-34 in relation to insulin resistance in patients with type 2 diabetes. Clin Ther 43:e230–e240. https://doi.org/10.1016/j.clinthera.2021.05.003CrossRefPubMed

39.

Tian C, Huang Z, Wen Z (2016) Associations between serum placental leucine aminopeptidase and pregnancy outcomes. Int J Gynecol Obstet 135:255–258. https://doi.org/10.1016/j.ijgo.2016.05.016CrossRef

Title: Fetal pancreas size and maternal serum biomarkers glycated albumin and insulin-regulated aminopeptidase provide no potential for early prediction of gestational diabetes mellitus
Authors: Filiz Yarsilikal Guleroglu
Aliye Balkan Ozmen
Isil Turan Bakirci
Sevilay Yavuz Dogu
Ibrahim Yılmaz
Ali Cetin
Publication date: 27-11-2022
Publisher: Springer Berlin Heidelberg
Keywords: Insulins
Gestational Diabetes
Gestational Diabetes
Insulins
Biomarkers
Published in: Archives of Gynecology and Obstetrics / Issue 5/2023
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-022-06860-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Fetal pancreas size and maternal serum biomarkers glycated albumin and insulin-regulated aminopeptidase provide no potential for early prediction of gestational diabetes mellitus

Abstract

Purpose

Materials and methods

Results

Conclusion

Clinical trials

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

Clinical trials

Please log in to get access to this content

Other articles of this Issue 5/2023

Management of levator ani avulsion: a systematic review and narrative synthesis

MicroRNAs in POI, DOR and POR

Effects of different oocyte cytoplasmic granulation patterns on embryo development and euploidy: a sibling oocyte control study

Unplanned pregnancies following the introduction of elexacaftor/tezacaftor/ivacaftor therapy in women with cystic fibrosis

Hysteroscopy in the new media: quality and reliability analysis of hysteroscopy procedures on YouTube™

Retraction Note: Luteal phase clomiphene citrate for ovulation induction in women with polycystic ovary syndrome