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The Role of Afamin and Other Trace Elements in the Prediction of GDM: a Tertiary Center Experience

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Abstract

The objective of this study was to evaluate the utility of first trimester maternal serum afamin levels together with vitamin E and various elements (zinc, copper, selenium, and magnesium) for the prediction of gestational diabetes mellitus (GDM). All pregnant women between 11th and 14th weeks of gestation admitted for combined test were asked to participate in the study. A total of 797 women gave permission to participate in the study between January and September 2019. Serum was obtained by centrifugation and samples were frozen and kept at − 80 °C. For final analysis, forty-three GDM patients and forty-four healthy controls were selected. Levels of afamin, vitamin E, zinc, copper, selenium, and magnesium were compared between groups. The mean levels of afamin were found to be higher in women with GDM without statistical significance (63.69 ± 82.33 vs 44.25 ± 32.25 mg/L, p = 0.149). Vitamin E levels were found to be higher in women with GDM compared to controls without any statistical significance (5.04 ± 5.33 vs 4.47 ± 3.83 μg/mL, p = 0.568). While first trimester copper concentrations were higher among diabetic women (187.26 ± 34.78 vs 175.17 ± 30.40 μg/L, p = 0.088), this was not statistically significant. The other element levels (zinc, selenium, and magnesium) were found to be similar between the two groups (p = 0.624, p = 0.088, p = 0.254, p = 0.872, respectively). The results of our study demonstrated that mean levels of afamin, vitamin E, and copper were higher in women with GDM compared to controls. Additionally, first trimester maternal zinc, selenium, and magnesium levels were similar between diabetic and healthy pregnant women. However, more studies are needed to clarify the relationship between blood trace concentrations and GDM.

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References

  1. Casey BM, Lucas MJ, McIntire DD, Leveno KJ (1997) Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol 90:869–873

    Article  CAS  Google Scholar 

  2. Karaçam Z, Çelik D (2019) The prevalence and risk factors of gestational diabetes mellitus in Turkey: a systematic review and meta-analysis. J Matern Fetal Neonatal Med:1–11

  3. 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

    Article  Google Scholar 

  4. Bulletins—Obstetrics CoP. ACOG practice bulletin No. 190: (2018) Gestational diabetes mellitus. Obstet Gynecol 131:e49-e64.

  5. Association AD (2004) Gestational diabetes mellitus. Diabetes Care 27:s88–s90

    Article  Google Scholar 

  6. Akgol S, Budak MS (2019) Obstetric and neonatal outcomes of pregnancies with mild gestational hyperglycemia diagnosed at gestational diabetes mellitus screening. Gyneco Obstet Reprod Med 25:138–141

    Article  Google Scholar 

  7. 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

    PubMed  Google Scholar 

  8. Amirian A, Rahnemaei FA, Abdi F (2020) Role of C-reactive Protein (CRP) or high-sensitivity CRP in predicting gestational diabetes mellitus: systematic review. Clinical Research & Reviews, Diabetes & Metabolic Syndrome

    Google Scholar 

  9. Correa PJ, Venegas P, Palmeiro Y, Albers D, Rice G, Roa J, Cortez J, Monckeberg M, Schepeler M, Osorio E, Illanes SE (2019) First trimester prediction of gestational diabetes mellitus using plasma biomarkers: a case-control study. J Perinat Med 47(2):161–168. https://doi.org/10.1515/jpm-2018-0120

    Article  CAS  PubMed  Google Scholar 

  10. Donovan BM, Nidey NL, Jasper EA, Robinson JG, Bao W, Saftlas AF, Ryckman KK (2018) First trimester prenatal screening biomarkers and gestational diabetes mellitus: a systematic review and meta-analysis. PLoS One 13(7):e0201319. https://doi.org/10.1371/journal.pone.0201319

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Pazdro R, Burgess JR (2010) The role of vitamin E and oxidative stress in diabetes complications. Mech Ageing Dev 131:276–286

    Article  CAS  Google Scholar 

  12. Martinoli L, Di Felice M, Seghieri G, Ciuti M, De Giorgio L, Fazzini A (1993) Plasma retinol and alpha-tocopherol concentrations in insulin-dependent diabetes mellitus: their relationship to microvascular complications. International Journal for Vitamin and Nutrition Research Internationale Zeitschrift fur Vitamin-und Ernahrungsforschung Journal International de vitaminologie et de Nutrition 63:87

    CAS  PubMed  Google Scholar 

  13. Santra D, Sawhney H, Aggarwal N, Majumdar S, Vasishta K (2003) Lipid peroxidation and vitamin E status in gestational diabetes mellitus. J Obstet Gynaecol Res 29:300–304

    Article  CAS  Google Scholar 

  14. Sharifipour F, Abedi P, Ciahkal SF, Jahanfar S, Mohaghegh Z, Zahedian M (2020) Serum vitamin E level and gestational diabetes mellitus: a systematic review and meta-analysis. Journal of Diabetes & Metabolic Disorders:1–9

  15. Tramontana A, Dieplinger B, Stangl G, Hafner E, Dieplinger H (2018) First trimester serum afamin concentrations are associated with the development of pre-eclampsia and gestational diabetes mellitus in pregnant women. Clin Chim Acta 476:160–166

    Article  CAS  Google Scholar 

  16. Hubalek M, Buchner H, Mörtl MG, Schlembach D, Huppertz B, Firulovic B, Köhler W, Hafner E, Dieplinger B, Wildt L, Dieplinger H (2014) The vitamin E-binding protein afamin increases in maternal serum during pregnancy. Clin Chim Acta 434(100):41–47. https://doi.org/10.1016/j.cca.2014.03.036

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Köninger A, Mathan A, Mach P, Frank M, Schmidt B, Schleussner E, Kimmig R, Gellhaus A, Dieplinger H (2018) Is afamin a novel biomarker for gestational diabetes mellitus? A pilot study. Reprod Biol Endocrinol 16(1):30. https://doi.org/10.1186/s12958-018-0338-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Tramontana A, Pablik E, Stangl G, Hartmann B, Dieplinger H, Hafner E (2018) Combination of first trimester serum afamin levels and three-dimensional placental bed vascularization as a possible screening method to detect women at-risk for adverse pregnancy complications like pre-eclampsia and gestational diabetes mellitus in low-risk pregnancies. Placenta 62:9–15

    Article  CAS  Google Scholar 

  19. Mishu FA, Muttalib M, Sultana B (2018) Serum zinc and copper levels in gestational diabetes mellitus in a tertiary care hospital of Bangladesh. BIRDEM Med J 8:52–55

    Article  Google Scholar 

  20. Karamali M, Heidarzadeh Z, Seifati SM, Samimi M, Tabassi Z, Hajijafari M, Asemi Z (2015) Esmaillzadeh A (2015) Zinc supplementation and the effects on metabolic status in gestational diabetes: a randomized, double-blind, placebo-controlled trial. J Diabetes Complicat 29(8):1314–1319. https://doi.org/10.1016/j.jdiacomp.07.001

    Article  Google Scholar 

  21. Lewandowska M, Sajdak S, Marciniak W, Lubiński J (2019) First trimester serum copper or zinc levels, and risk of pregnancy-induced hypertension. Nutrients 11:2479

    Article  CAS  Google Scholar 

  22. Hao Y, Pang Y, Yan H, Zhang Y, Liu J, Jin L, Yan L, Chen D, Hu L, Liu Q, Qin Y, Wang B, Li Z, Ye R, Zhang L, Ren A (2019) Association of maternal serum copper during early pregnancy with the risk of spontaneous preterm birth: a nested case-control study in China. Environ Int 122:237–243. https://doi.org/10.1016/j.envint.2018.11.009

    Article  CAS  PubMed  Google Scholar 

  23. Alebic-Juretic A, Frkovic A (2005) Plasma copper concentrations in pathological pregnancies. J Trace Elem Med Biol 19:191–194

    Article  CAS  Google Scholar 

  24. Song X, Li B, Li Z, Wang J, Zhang D (2017) High serum copper level is associated with an increased risk of preeclampsia in Asians: a meta-analysis. Nutr Res 39:14–24

    Article  CAS  Google Scholar 

  25. Li P, Yin J, Zhu Y, Li S, Chen S, Sun T, Shan Z, Wang J, Shang Q, Li X, Yang W, Liu L (2019) Association between plasma concentration of copper and gestational diabetes mellitus. Clin Nutr 38:2922–2927

    Article  CAS  Google Scholar 

  26. Wang Y, Tan M, Huang Z, Sheng L, Ge Y, Zhang H, Jiang M, Zhang G (2002) Elemental contents in serum of pregnant women with gestational diabetes mellitus. Biol Trace Elem Res 88:113–118

    Article  CAS  Google Scholar 

  27. Akhlaghi F, Bagheri SM, Rajabi O (2012) A comparative study of relationship between micronutrients and gestational diabetes. ISRN obstetrics and gynecology

  28. Al-Saleh E, Nandakumaran M, Al-Rashdan I, Al-Harmi J, Al-Shammari M (2007) Maternal-foetal status of copper, iron, molybdenum, selenium and zinc in obese gestational diabetic pregnancies. Acta Diabetol 44:106–113

    Article  CAS  Google Scholar 

  29. Moshfeghy Z, Bashiri K, Dabbaghmanesh MH, Akbarzadeh M, Asadi N, Sayadi M (2020) The predictive value of selenium in diagnosis of gestational diabetes: a nested case-control study. Int J Gen Med 13:53–60

    Article  CAS  Google Scholar 

  30. Askari G, Iraj B, Salehi-Abargouei A, Fallah AA, Jafari T (2015) The association between serum selenium and gestational diabetes mellitus: a systematic review and meta-analysis. J Trace Elem Med Biol 29:195–201

    Article  CAS  Google Scholar 

  31. Kilinc M, Guven MA, Ezer M, Ertas IE, Coskun A (2008) Evaluation of serum selenium levels in Turkish women with gestational diabetes mellitus, glucose intolerants, and normal controls. Biol Trace Elem Res 123:35–40

    Article  CAS  Google Scholar 

  32. Asemi Z, Jamilian M, Mesdaghinia E, Esmaillzadeh A (2015) Effects of selenium supplementation on glucose homeostasis, inflammation, and oxidative stress in gestational diabetes: randomized, double-blind, placebo-controlled trial. Nutrition 31:1235–1242

    Article  CAS  Google Scholar 

  33. Plows JF, Reynolds CM, Vickers MH, Baker PN, Stanley JL (2019) Nutritional supplementation for the prevention and/or treatment of gestational diabetes mellitus. Curr Diabetes Rep 19:73

    Article  Google Scholar 

  34. Asemi Z, Karamali M, Jamilian M, Foroozanfard F, Bahmani F, Heidarzadeh Z, Benisi-Kohansal S, Surkan PJ, Esmaillzadeh A (2015) Magnesium supplementation affects metabolic status and pregnancy outcomes in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 102:222–229

    Article  CAS  Google Scholar 

  35. Naser W, Adam I, Rayis DA, Ahmed MA, Hamdan HZ (2019) Serum magnesium and high-sensitivity C-reactive protein as a predictor for gestational diabetes mellitus in Sudanese pregnant women. BMC Pregnancy Childbirth 19:1–5

    Article  CAS  Google Scholar 

  36. Nabouli M, Lassoued L, Bakri Z, Moghannem M (2016) Modification of total magnesium level in pregnant Saudi women developing gestational diabetes mellitus. Diabetes Metab Syndr Clin Res Rev 10:183–185

    Article  CAS  Google Scholar 

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Acknowledgments

We would like to thank all the participants of this study

Funding

This study was supported by University of Health Sciences Scientific Research Coordination Unit. Project Number: 2019/070.

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Correspondence to Hasan Eroğlu.

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Eroğlu, H., Örgül, G., Tonyalı, N.V. et al. The Role of Afamin and Other Trace Elements in the Prediction of GDM: a Tertiary Center Experience. Biol Trace Elem Res 199, 4418–4422 (2021). https://doi.org/10.1007/s12011-020-02559-0

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  • DOI: https://doi.org/10.1007/s12011-020-02559-0

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