Jsmc-10383

CORRELATION OF SERUM FERRITIN, HEMOGLOBIN, AND PLATELET LEVELS IN PREGNANT WOMEN WITH GESTATIONAL DIABETES  

Sallama Kamel Nasir a, Sara Shakir Mahmood b, and Rezan Abdulrahman Ali c

a  Department of OBS & GYN, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

b Directory of Health of Sulaimani, Ministry of Health, Kurdistan Region, Iraq.

c Department of OBS & GYN, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

Submitted: 27/5/2022; Accepted: 21/10/2022; Published: 21/12/2022

DOI Link: https://doi.org/10.17656/jsmc.10383 

ABSTRACT 

Background 

Gestational diabetes mellitus (GDM) affects approximately 7% of all pregnancies. Pregnancy which is regarded as a pro-inflammatory state “mostly because of the mitochondria-rich placenta,” is a condition that favors oxidative stress. A transitional metal, particularly iron, abundant in the placenta, is significant in producing free radicals. Various studies indicate that free radicals play a remarkable role in GDM. Iron storage and status in the body can be reliably assessed by serum ferritin as the standard measurement.

Objectives 

The present study aimed to measure the serum ferritin level, hemoglobin, and platelet count in women with GDM and compare it with those of women experiencing a normal pregnancy.

Patients and Methods

This case-control study was conducted in Sulaimani Maternity Teaching Hospital in Sulaimani city, Iraq. Over 18 months, they were starting from Jan 1, 2020, till Jun 30, 2021. The study sample consisted of 160 pregnant women in the third trimester of their pregnancy. The participating women were divided into a study group and a control group. The study group consisted of 80 pregnant women with GDM, which OGTT detected from 24 to 28 weeks of their pregnancy. The control group consisted of 80 pregnant women who had a normal and healthy pregnancy, did not have GDM, and were in their third trimester. For both groups, mean platelet volume, platelet count, hemoglobin level, and serum ferritin level were measured, and the two groups were compared in terms of these variables.

Results

Compared to the control group, the group with GDM had a significantly higher level of mean serum ferritin (29.04±16.09 ng/ml versus 37.97±29.42 ng/ml) (P=0.02). However, the study and control groups were not statistically different regarding their mean hemoglobin levels (12.26±0.63g/dl versus 12.14±0.60g/dl) (P-value=0.19). In addition, the study group had a significantly higher mean platelet count than the control group (246.71x 103/µl±54.02 versus 203.52 x103/µl±54.1) (P<0.001). However, no significant difference was seen between the study group and the control group regarding their mean platelet volume (MPV) (9.50±1.25 1015/L versus 9.35±0.95 1015/L) (P=0.41). 

Conclusion

Compared with women with normal pregnancy, GDM women have higher serum ferritin levels and platelet count; therefore, serum ferritin can be regarded as a marker for GDM pathogenesis. However, it is recommended that serum ferritin levels should be measured in early pregnancy to evaluate the risk of GDM development in those with high serum ferritin levels.

KEYWORDS

Gestational diabetes, serum ferritin, hemoglobin, platelet count.

References 

1. American Diabetes Association. 2. Classification and diagnosis of diabetes. Diabetes care. 2016 Jan 1;39(Supplement_1):S13-22.

2. Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes care. 2007 Jul 1;30(Supplement_2): S141-6.

3. Tushuizen ME, Bunck MC, Pouwels PJ, Bontemps S, Van Waesberghe JH, Schindhelm RK, Mari A, Heine RJ, Diamant M. Pancreatic fat content and β-cell function in men with and without type 2 diabetes. Diabetes care. 2007 Nov 1;30(11):2916-21.

4. Orino K, Watanabe K. Molecular, physiological and clinical aspects of the iron storage protein ferritin. The Veterinary Journal. 2008 Nov 1;178(2):191-201.

5. Lim MK, Lee CK, Ju YS, Cho YS, Lee MS, Yoo B, Moon HB. Serum ferritin as a serologic marker of activity in systemic lupus erythematosus. Rheumatology international. 2001 Apr;20(3):89-93.

6. Bothwell TH. Iron requirements in pregnancy and strategies to meet them. The American journal of clinical nutrition. 2000 Jul 1;72(1):257S-64S.

7. Drysdale J, Arosio P, Invernizzi R, Cazzola M, Volz A, Corsi B, Biasiotto G, Levi S. Mitochondrial ferritin: a new player in iron metabolism. Blood Cells, Molecules, and Diseases. 2002 Nov 1;29(3):376-83.

8. Puntarulo S. Iron, oxidative stress and human health. Molecular aspects of medicine. 2005 Aug 1;26(4-5):299-312.

9. Halliwell B, Gutteridge JM. Free radicals in biology and medicine. Oxford university press, USA; 2015.

10. Hansen JB, Moen IW, Mandrup-Poulsen T. Iron: the hard player in diabetes pathophysiology. Acta Physiologica. 2014 Apr;210(4):717-32.0

11. Lenzen S. Oxidative stress: the vulnerable β-cell. Biochemical Society Transactions. 2008 Jun 1;36(3):343-7.

12. Zein S, Rachidi S, Hininger-Favier I. Is oxidative stress induced by iron status associated with gestational diabetes mellitus? Journal of Trace Elements in Medicine and Biology. 2014 Jan 1;28(1):65-9.

13. Domellöf M, Thorsdottir I, Thorstensen K. Health effects of different dietary iron intakes: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food & nutrition research. 2013 Jan 1;57(1):21667.

14. Shahbaz A, Cicekler H, Aynioglu O, Isik H, Ozmen U. Comparison of the predictive value of plateletcrit with various other blood parameters in gestational diabetes development. Journal of obstetrics and gynecology. 2016 Jul 3;36(5):589-93

15. Zaccardi F, Rocca B, Pitocco D, Tanese L, Rizzi A, Ghirlanda G. Platelet mean volume, distribution width, and count in type 2 diabetes, impaired fasting glucose, and metabolic syndrome: a meta-analysis. Diabetes/metabolism research and reviews. 2015 May;31(4):402-10

16. Li Y, Ren X, He L, Li J, Zhang S, Chen W. Maternal age and the risk of gestational diabetes mellitus: a systematic review and meta-analysis of over 120 million participants. Diabetes research and clinical practice. 2020 Apr 1;162:108044.

17. Yaping X, Chunhong L, Huifen Z, Fengfeng H, Huibin H, Meijing Z. Risk factors associated with gestational diabetes mellitus: a retrospective case-control study. International Journal of Diabetes in Developing Countries. 2021 Apr 7:1-0.

18. Sharifi F, Ziaee A, Feizi A, Mousavinasab N, Anjomshoaa A, Mokhtari P. Serum ferritin concentration in gestational diabetes mellitus and risk of subsequent development of early postpartum diabetes mellitus. Diabetes, metabolic syndrome, and obesity: targets and therapy. 2010;3:413.

19. Das CC, Sreekala KN, Geetha N. Serum Ferritin in Gestational Diabetes.

20. Rasmussen S, Bergsjø P, Jacobsen G, Haram K, Bakketeig LS. Hemoglobin and serum ferritin in pregnancy—correlation with smoking and body mass index. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2005 Nov 1;123(1):27-34.

21. Kim HY, Kim J, Noh E, Ahn KH, Cho GJ, Hong SC, Oh MJ, Kim HJ. Pre-pregnancy hemoglobin levels and gestational diabetes mellitus in pregnancy. Diabetes Research and Clinical Practice. 2021 Jan 1;171:108608.

22. Mogaddam MR, Ardebili NS, Kariman N. The Relation Between the Incidence Rate of Second and Third Trimester Hemoglobin and the Incidence of Preeclampsia and Gestational Diabetes: A Cohort Study. Crescent Journal of Medical and Biological Sciences. 2019 Jan 1;6(1).

23. Sak ME, Soydinç HE, Özler A, Evsen MS, Turgut A, Sak S, Gül T. Platelet profile in patients with gestational diabetes: a retrospective study. Journal of the Turkish German Gynecological Association. 2012;13(4):223.

24. Erikçi AA, Muhçu M, Dündar Ö, Öztürk A. Could mean platelet volume be a predictive marker for gestational diabetes mellitus? Hematology. 2008 Feb 1;13(1):46-8

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