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Iron and Oxidative Stress in Gestational Diabetes

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Nutrition and Diet in Maternal Diabetes

Part of the book series: Nutrition and Health ((NH))

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Abstract

Gestational Diabetes mellitus (GDM) is a significantly growing problem in worldwide healthcare, and it is one of the most common pregnancy complications associated with increased perinatal and long‐term adverse effects for both mothers and newborns. Although sufficient iron stores during pregnancy are essential to prevent negative outcomes for both infants and mothers, excess iron increases the risk of GDM. Accumulating data suggest that a high iron intake might increase the risk of GDM and of Type 2 diabetes. Moderately elevated serum ferritin early in pregnancy should be considered as a predictive factor for GDM, and routine evaluation of ferritin levels and other parameters of iron homeostasis should guide supplementation and help identifying and preventing GDM In high‐risk women by providing them with dietary advice.

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Abbreviations

CDC:

Centers for disease control and prevention

CRP:

C-reactive protein

GDM:

Gestational diabetes mellitus

OS:

Oxidative stress

T2D:

Type 2 diabetes

WHO:

World Health Organization

TBARS:

Thiobarbituric acid-reactive substances

References

  1. Rani PR, Begum J. Screening and diagnosis of gestational diabetes mellitus, where do we stand. J Clin Diagn Res. 2016;10(4):QE01–4.

    Google Scholar 

  2. Kennelly MA, McAuliffe FM. Prediction and prevention of gestational diabetes: an update of recent literature. Eur J Obstet Gynecol Reprod Biol. 2016;202:92–8.

    Article  CAS  PubMed  Google Scholar 

  3. American Diabetes A. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013;36(Suppl 1):S67–74.

    Google Scholar 

  4. Buchanan TA, Xiang A, Kjos SL, Watanabe R. What is gestational diabetes? Diabetes Care. 2007;30(Suppl 2):S105–11.

    Article  CAS  PubMed  Google Scholar 

  5. Damm P, Houshmand-Oeregaard A, Kelstrup L, Lauenborg J, Mathiesen ER, Clausen TD. Gestational diabetes mellitus and long-term consequences for mother and offspring: a view from Denmark. Diabetologia. 2016;59(7):1396–9.

    Article  CAS  PubMed  Google Scholar 

  6. Dabelea D, Mayer-Davis EJ, Lamichhane AP, D’Agostino RB Jr, Liese AD, Vehik KS, et al. Association of intrauterine exposure to maternal diabetes and obesity with type 2 diabetes in youth: the SEARCH case-control study. Diabetes Care. 2008;31(7):1422–6.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Weinberg ED. Are iron supplements appropriate for iron replete pregnant women? Med Hypotheses. 2009;73(5):714–5.

    Article  CAS  PubMed  Google Scholar 

  8. Casanueva E, Viteri FE. Iron and oxidative stress in pregnancy. J Nutr. 2003;133(5 Suppl 2):1700S–8S.

    CAS  PubMed  Google Scholar 

  9. CfDCa Prevention. Recommendations to prevent and control iron deficiency in the United States. MMWR Recomm Rep. 1998;7(4):1–29.

    Google Scholar 

  10. WHO. Assessing the iron status of populations: including literature reviews: report of a joint world health organization/centers for disease control and prevention technical consultation on the assessment of iron status at the population level, Geneva, Switzerland, 6–8 2004 WHO document production services. Geneva: World Health Organization, 2004.

    Google Scholar 

  11. WHO. WHO: Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva: World Health Organisation: 2011.

    Google Scholar 

  12. WHO. Iron deficiency anemia assessment prevention and control: a guide for program managers. 2001.

    Google Scholar 

  13. Milman N. Prepartum anaemia: prevention and treatment. Ann Hematol. 2008;87(12):949–59.

    Article  CAS  PubMed  Google Scholar 

  14. McDonagh M, Cantor A, Bougatsos C, Dana T, Blazina I. Routine iron supplementation and screening for iron deficiency anemia in pregnant women: a systematic review to update the US preventive services task force recommendation. Rockville (MD)2015.

    Google Scholar 

  15. Galan P, Yoon HC, Preziosi P, Viteri F, Valeix P, Fieux B, et al. Determining factors in the iron status of adult women in the SU. VI. MAX study. Supplementation en VItamines et Mineraux AntioXydants. Eur J Clin Nutr. 1998;52(6):383–8.

    Article  CAS  PubMed  Google Scholar 

  16. Barrett JF, Whittaker PG, Williams JG, Lind T. Absorption of non-haem iron from food during normal pregnancy. BMJ. 1994;309(6947):79–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Bradley J, Leibold EA, Harris ZL, Wobken JD, Clarke S, Zumbrennen KB, et al. Influence of gestational age and fetal iron status on IRP activity and iron transporter protein expression in third-trimester human placenta. Am J Physiol Regul Integr Comp Physiol. 2004;287(4):R894–901.

    Article  CAS  PubMed  Google Scholar 

  18. Cheng Y, Zak O, Aisen P, Harrison SC, Walz T. Structure of the human transferrin receptor-transferrin complex. Cell. 2004;116(4):565–76.

    Article  CAS  PubMed  Google Scholar 

  19. Bastin J, Drakesmith H, Rees M, Sargent I, Townsend A. Localisation of proteins of iron metabolism in the human placenta and liver. Br J Haematol. 2006;134(5):532–43.

    Article  CAS  PubMed  Google Scholar 

  20. Collard KJ. Iron homeostasis in the neonate. Pediatrics. 2009;123(4):1208–16.

    Article  PubMed  Google Scholar 

  21. Fleming AF, Ghatoura GB, Harrison KA, Briggs ND, Dunn DT. The prevention of anaemia in pregnancy in primigravidae in the guinea savanna of Nigeria. Ann Trop Med Parasitol. 1986;80(2):211–33.

    Article  CAS  PubMed  Google Scholar 

  22. Milman N, Agger AO, Nielsen OJ. Iron supplementation during pregnancy. Effect on iron status markers, serum erythropoietin and human placental lactogen. A placebo controlled study in 207 Danish women. Dan Med Bull. 1991;38(6):471–6.

    CAS  PubMed  Google Scholar 

  23. Byg KE, Milman N, Hansen S, Agger AO. Serum ferritin is a reliable, non-invasive test for iron status in pregnancy: comparison of ferritin with other iron status markers in a longitudinal study on healthy pregnant women. Erythropoiesis. Hematol. 2000;5(4):319–25.

    Article  CAS  Google Scholar 

  24. De Benaze C, Galan P, Wainer R, Hercberg S. [Prevention of iron-deficiency anemia in pregnancy using early iron supplementation: a controlled trial]. Rev Epidemiol Sante Publique. 1989;37(2):109–18. Prevention de l’anemie ferriprive au cours de la grossesse par une supplementation martiale precoce: un essai controle.

    Google Scholar 

  25. Milman N, Byg KE, Agger AO. Hemoglobin and erythrocyte indices during normal pregnancy and postpartum in 206 women with and without iron supplementation. Acta Obstet Gynecol Scand. 2000;79(2):89–98.

    Article  CAS  PubMed  Google Scholar 

  26. Cogswell ME, Parvanta I, Ickes L, Yip R, Brittenham GM. Iron supplementation during pregnancy, anemia, and birth weight: a randomized controlled trial. Am J Clin Nutr. 2003;78(4):773–81.

    CAS  PubMed  Google Scholar 

  27. Pena-Rosas JP, De-Regal LM, Garcia-Casal MN, Dowswell T. Daily oral iron supplementation during pregnancy. Cochrane Database Syst Rev. 2015(7):CD004736.

    Google Scholar 

  28. Zein S, Rachidi S, Hininger-Favier I. Is oxidative stress induced by iron status associated with gestational diabetes mellitus? J Trace Elem Med Biol. 2014;28(1):65–9.

    Article  CAS  PubMed  Google Scholar 

  29. Hansen JB, Moen IW, Mandrup-Poulsen T. Iron: the hard player in diabetes pathophysiology. Acta Physiol (Oxf). 2014;210(4):717–32.

    Article  CAS  Google Scholar 

  30. Arija V, Fernandez-Cao JC, Basora J, Bullo M, Aranda N, Estruch R, et al. Excess body iron and the risk of type 2 diabetes mellitus: a nested case-control in the PREDIMED (PREvention with MEDiterranean Diet) study. Br J Nutr. 2014;112(11):1896–904.

    Article  CAS  PubMed  Google Scholar 

  31. Rajpathak SN, Wylie-Rosett J, Gunter MJ, Negassa A, Kabat GC, Rohan TE, et al. Biomarkers of body iron stores and risk of developing type 2 diabetes. Diabetes Obes Metab. 2009;11(5):472–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Rajpathak SN, Crandall JP, Wylie-Rosett J, Kabat GC, Rohan TE, Hu FB. The role of iron in type 2 diabetes in humans. Biochim Biophys Acta. 2009;1790(7):671–81.

    Article  CAS  PubMed  Google Scholar 

  33. Abril-Ulloa V, Flores-Mateo G, Sola-Alberich R, Manuel-y-Keenoy B, Arija V. Ferritin levels and risk of metabolic syndrome: meta-analysis of observational studies. BMC Public Health. 2014;14:483.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Song Y, Manson JE, Buring JE, Liu S. A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: the women’s health study. Diabetes Care. 2004;27(9):2108–15.

    Article  CAS  PubMed  Google Scholar 

  35. Lao TT, Tam KF. Maternal serum ferritin and gestational impaired glucose tolerance. Diabetes Care. 1997;20(9):1368–9.

    Article  CAS  PubMed  Google Scholar 

  36. Lao TT, Chan PL, Tam KF. Gestational diabetes mellitus in the last trimester—a feature of maternal iron excess? Diabet Med. 2001;18(3):218–23.

    Article  CAS  PubMed  Google Scholar 

  37. Tarim E, Kilicdag E, Bagis T, Ergin T. High maternal hemoglobin and ferritin values as risk factors for gestational diabetes. Int J Gynaecol Obstet. 2004;84(3):259–61.

    Article  CAS  PubMed  Google Scholar 

  38. Lao TT, Chan LY, Tam KF, Ho LF. Maternal hemoglobin and risk of gestational diabetes mellitus in Chinese women. Obstet Gynecol. 2002;99(5 Pt 1):807–12.

    CAS  PubMed  Google Scholar 

  39. Lao TT, Ho LF. Impact of iron deficiency anemia on prevalence of gestational diabetes mellitus. Diabetes Care. 2004;27(3):650–6.

    Article  PubMed  Google Scholar 

  40. Zein S, Rachidi S, Awada S, Osman M, Al-Hajje A, Shami N, et al. High iron level in early pregnancy increased glucose intolerance. J Trace Elem Med Biol. 2015;30:220–5.

    Article  CAS  PubMed  Google Scholar 

  41. Khambalia AZ, Aimone A, Nagubandi P, Roberts CL, McElduff A, Morris JM, et al. High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review. Diabet Med. 2015.

    Google Scholar 

  42. Fu S, Li F, Zhou J, Liu Z. The relationship between body iron status, iron intake and gestational diabetes: a systematic review and meta-analysis. Med (Baltimore). 2016;95(2):e2383.

    Article  Google Scholar 

  43. Moyer VA. Force USPST. screening for gestational diabetes mellitus: U.S. preventive services task force recommendation statement. Ann Intern Med. 2014;160(6):414–20.

    Article  PubMed  Google Scholar 

  44. Chan KK, Chan BC, Lam KF, Tam S, Lao TT. Iron supplement in pregnancy and development of gestational diabetes–a randomised placebo-controlled trial. BJOG. 2009;116(6):789–97; discussion 97–8.

    Google Scholar 

  45. Bo S, Menato G, Villois P, Gambino R, Cassader M, Cotrino I, et al. Iron supplementation and gestational diabetes in midpregnancy. Am J Obstet Gynecol. 2009;201(2):158 ;e1–6.

    Google Scholar 

  46. Helin A, Kinnunen TI, Raitanen J, Ahonen S, Virtanen SM, Luoto R. Iron intake, haemoglobin and risk of gestational diabetes: a prospective cohort study. BMJ open. 2012;2(5).

    Google Scholar 

  47. Fernandez-Real JM, Lopez-Bermejo A, Ricart W. Cross-talk between iron metabolism and diabetes. Diabetes. 2002;51(8):2348–54.

    Article  CAS  PubMed  Google Scholar 

  48. Bowers K, Yeung E, Williams MA, Qi L, Tobias DK, Hu FB, et al. A prospective study of prepregnancy dietary iron intake and risk for gestational diabetes mellitus. Diabetes Care. 2011;34(7):1557–63.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Darling AM, Mitchell AA, Werler MM. Preconceptional iron intake and gestational diabetes mellitus. Int J Environ Res Public Health. 2016;13(6).

    Google Scholar 

  50. Buijsse B, Feskens EJ, Moschandreas J, Jansen EH, Jacobs DR Jr, Kafatos A, et al. Oxidative stress, and iron and antioxidant status in elderly men: differences between the Mediterranean south (Crete) and northern Europe (Zutphen). Eur J Cardiovasc Prev Rehabil. 2007;14(4):495–500.

    Article  PubMed  Google Scholar 

  51. Tobias DK, Zhang C, Chavarro J, Bowers K, Rich-Edwards J, Rosner B, et al. Prepregnancy adherence to dietary patterns and lower risk of gestational diabetes mellitus. Am J Clin Nutr. 2012;96(2):289–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Zhang C, Ning Y. Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence. Am J Clin Nutr. 2011;94(6 Suppl):1975S–9S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Afkhami-Ardekani M, Rashidi M. Iron status in women with and without gestational diabetes mellitus. J Diabetes Complications. 2009;23(3):194–8.

    Article  PubMed  Google Scholar 

  54. Leonard SS, Harris GK, Shi X. Metal-induced oxidative stress and signal transduction. Free Radic Biol Med. 2004;37(12):1921–42.

    Article  CAS  PubMed  Google Scholar 

  55. Wei W, Liu Q, Tan Y, Liu L, Li X, Cai L. Oxidative stress, diabetes, and diabetic complications. Hemoglobin. 2009;33(5):370–7.

    Article  CAS  PubMed  Google Scholar 

  56. Whittaker P, Hines FA, Robl MG, Dunkel VC. Histopathological evaluation of liver, pancreas, spleen, and heart from iron-overloaded Sprague-Dawley rats. Toxicol Pathol. 1996;24(5):558–63.

    Article  CAS  PubMed  Google Scholar 

  57. Lenzen S. Oxidative stress: the vulnerable beta-cell. Biochem Soc Trans. 2008;36(Pt 3):343–7.

    Article  CAS  PubMed  Google Scholar 

  58. Kom GD, Schwedhelm E, Nielsen P, Boger RH. Increased urinary excretion of 8-iso-prostaglandin F2alpha in patients with HFE-related hemochromatosis: a case-control study. Free Radic Biol Med. 2006;40(7):1194–200.

    Article  CAS  PubMed  Google Scholar 

  59. Quarles CD Jr, Marcus RK, Brumaghim JL. Competitive binding of Fe3+, Cr3+, and Ni2+ to transferrin. J Biol Inorg Chem. 2011;16(6):913–21.

    Article  CAS  PubMed  Google Scholar 

  60. Vincent JB. Is the pharmacological mode of action of chromium(III) as a second messenger? Biol Trace Elem Res. 2015;166(1):7–12.

    Article  CAS  PubMed  Google Scholar 

  61. Ranasinghe P, Pigera S, Galappatthy P, Katulanda P, Constantine GR. Zinc and diabetes mellitus: understanding molecular mechanisms and clinical implications. Daru. 2015;23:44.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Puntarulo S. Iron, oxidative stress and human health. Mol Aspects Med. 2005;26(4–5):299–312.

    Article  CAS  PubMed  Google Scholar 

  63. Hininger I, Favier M, Arnaud J, Faure H, Thoulon JM, Hariveau E, et al. Effects of a combined micronutrient supplementation on maternal biological status and newborn anthropometrics measurements: a randomized double-blind, placebo-controlled trial in apparently healthy pregnant women. Eur J Clin Nutr. 2004;58(1):52–9.

    Article  CAS  PubMed  Google Scholar 

  64. Lappas M, Hiden U, Desoye G, Froehlich J, Hauguel-de Mouzon S, Jawerbaum A. The role of oxidative stress in the pathophysiology of gestational diabetes mellitus. Antioxid Redox Signal. 2011;15(12):3061–100.

    Google Scholar 

  65. Qiu C, Hevner K, Abetew D, Enquobahrie DA, Williams MA. Oxidative DNA damage in early pregnancy and risk of gestational diabetes mellitus: a pilot study. Clin Biochem. 2011;44(10–11):804–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Zein S, Rachidi S, Shami N, Sharara I, Cheikh-Ali K, Gauchez AS, Moulis JM, Ayoubi JM, Salameh P, Hininger-Favier. Association between iron level, glucose impairment and increased DNA damage during pregnancy. J Trace Elem Med Biol. 2016; doi:10.1016/j.jtemb.2016.11.006 [Epub ahead of print].

  67. Lachili B, Hininger I, Faure H, Arnaud J, Richard MJ, Favier A, et al. Increased lipid peroxidation in pregnant women after iron and vitamin C supplementation. Biol Trace Elem Res. 2001;83(2):103–10.

    Article  CAS  PubMed  Google Scholar 

  68. Devrim E, Tarhan I, Erguder IB, Durak I. Oxidant/antioxidant status of placenta, blood, and cord blood samples from pregnant women supplemented with iron. J Soc Gynecol Investig. 2006;13(7):502–5.

    Article  CAS  PubMed  Google Scholar 

  69. Viteri FE, Casanueva E, Tolentino MC, Diaz-Frances J, Erazo AB. Antenatal iron supplements consumed daily produce oxidative stress in contrast to weekly supplementation in Mexican non-anemic women. Reprod Toxicol. 2012;34(1):125–32.

    Article  CAS  PubMed  Google Scholar 

  70. Berggren KL, Chen J, Fox J, Miller J, Dodds L, Dugas B, et al. Neonatal iron supplementation potentiates oxidative stress, energetic dysfunction and neurodegeneration in the R6/2 mouse model of Huntington’s disease. Redox Biol. 2015;4:363–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Zein S, Sitti F, Osman M, Arnaud J, Batandier C, Gauchez AS, et al. Middle iron-enriched fructose diet on gestational diabetes risk and on oxidative stress in offspring rats. Biol Trace Elem Res. 2016.

    Google Scholar 

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Authors and Affiliations

  1. Department of Biology and Nutrition, Faculty of Pharmacy , INSERM U1055, Laboratory of Fundamental and Applied Bioenergetics (LBFA), Université Grenoble Alpes, Grenoble, France

    Isabelle Hininger-Favier & Jean-Marc Moulis

  2. Bioscience and Biotechnology Institute (BIG), CEA, Grenoble, France

    Jean-Marc Moulis

  3. Department of Gynecology and Obstetrics, Hôpital Foch, Suresnes, France

    Jean-Marc Ayoubi

Authors
  1. Isabelle Hininger-Favier
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  2. Jean-Marc Moulis
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  3. Jean-Marc Ayoubi
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Correspondence to Isabelle Hininger-Favier .

Editor information

Editors and Affiliations

  1. Department of Nutrition, King’s College London, London, United Kingdom

    Rajkumar Rajendram

  2. Department of Nutrition, King’s College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Hininger-Favier, I., Moulis, JM., Ayoubi, JM. (2018). Iron and Oxidative Stress in Gestational Diabetes. In: Rajendram, R., Preedy, V., Patel, V. (eds) Nutrition and Diet in Maternal Diabetes. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-56440-1_36

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  • DOI: https://doi.org/10.1007/978-3-319-56440-1_36

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