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.
Similar content being viewed by others
References
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
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
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
Bulletins—Obstetrics CoP. ACOG practice bulletin No. 190: (2018) Gestational diabetes mellitus. Obstet Gynecol 131:e49-e64.
Association AD (2004) Gestational diabetes mellitus. Diabetes Care 27:s88–s90
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
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
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
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
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
Pazdro R, Burgess JR (2010) The role of vitamin E and oxidative stress in diabetes complications. Mech Ageing Dev 131:276–286
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
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
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
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
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
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
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
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
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
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
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
Alebic-Juretic A, Frkovic A (2005) Plasma copper concentrations in pathological pregnancies. J Trace Elem Med Biol 19:191–194
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
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
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
Akhlaghi F, Bagheri SM, Rajabi O (2012) A comparative study of relationship between micronutrients and gestational diabetes. ISRN obstetrics and gynecology
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
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
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
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
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
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
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
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
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
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.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12011-020-02559-0