الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Gestational diabetes mellitus (GDM) affects approximately 7% of all pregnancies. Pregnancy is a condition that favors oxidative stress. A transitional metal, especially iron, which is particularly abundant in the placenta, is important in the production of free radicals. Also, studies have shown that free radicals have a role in GDM. Several lines of evidence suggest that iron play may a role in the pathogenesis of type 2 diabetes. Several epidemiological studies have reported a positive association between high body iron stores, as measured by circulating ferritin level, and the risk of type 2 diabetes and of other insulin resistant states such as the metabolic syndrome, gestational diabetes and polycystic ovarian syndrome. In addition, increased dietary intake of iron, especially that of heme iron, is associated with risk of type 2 diabetes in apparently healthy populations.Several clinical trials have suggested that phlebotomy induced reduction in body iron levels may improve insulin sensitivity in humans. However, no studies have yet directly evaluated the effect of reducing iron intake or body iron levels on the risk of developing type 2 diabetes. This study was held on patients had antenatal care follow up in the diabetic clinic and healthy pregnant ladies having their routine antenatal care visits in Ain Shams University Maternity hospital outpatients clinic from January 2008 to January 2009. Patients were divided into three groups in which: group I: 25 pregnant patients at 24 -28 weeks of gestation with gestational diabetes, group II: 25 pregnant non-diabetics at the same gestational age, group III: 10 healthy (non-pregnant, non-diabetic) women.The mean concentration of serum ferritin was significantly higher than in healthy pregnant [71.4 ± 22.7 Vs 29 ± 14.7] ng/dl and the mean level of serum iron was significantly higher in GDM group than in healthy pregnant [115 ± 23 Vs 67 ± 22.6] ụg/dL (P<0.001).Also, we found that the mean transferrin saturation was significantly higher in the GDM group (32.2 ± 4.7%) than in healthy pregnant group (23.4 ± 4%) (P< 0.001). In addition, we found that there is highly significant positive correlation between HOMA IR and serum insulin (r = 0.96), FBS (r = 0.57), 2hr PP(r = 0.39) (P< 0.001) among the three groups and there is highly significant positive correlation between HOMA IR and iron (r =0.76), ferritin (r =0.66), TIBC (r =0.69) and transferrin saturation (r =0.7) (P< 0.001) among the three groups and non significant correlation between serum iron and Hb A1c in GDM group (P >0.05).The results showed that the mean hemoglobin was significantly higher in the GDM group than in healthy pregnant group (12.1±0.55 vs. 11.1 ± 0.54 g/dl) (P< 0.001).Also when mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were analyzed, they were both significantly higher in the GDM group than in healthy pregnant group (90 ± 3.6 vs. 83.3 ± 2.9 fl) (30.3 ± 1.8 Vs. 27.1 ± 2 pg) respectively (P<0.001). Elevated oxidative stress may play a direct role in hyperglycemia. Iron supplementation may improve pregnancy outcome when the mother is iron deficient it is also possible that prophylactic supplementation may increase risk when the mother does not have iron deficiency or iron deficiency anemiaSo, it is recommended that further studies should be done to evaluate the risk of prophylactic iron supplementation on developing of gestational diabetes mellitus, and not to give iron supplementation to the pregnant women until iron deficiency is suspected.