Maternal serum resistin level can effectively predict gestational diabetes mellitus irrespective of gestational age

Corresponding and presenting author:

Dr. Tahmina Ferdousi, Phase B Resident (Endocrinology and Metabolism), Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Cell: +8801712-128965, E-mail: tahminaferdousi@gmail.com

ABSTRACT

Background: Resistin is an inflammatory cytokine released from adipose tissue that is thought to play an important role in the pathogenesis of gestational diabetes mellitus (GDM) by increasing insulin resistance and reducing insulin secretion.

Objectives: This study aimed to determine the level of serum resistin in GDM patients across all trimesters and find out if it differs from pregnant mothers with normal glucose tolerance (NGT).

Methods: This cross-sectional study included 80 pregnant women with GDM (25, 25 & 30 in 1^st, 2^nd and 3^rd trimesters respectively) and an equal number of NGT mothers after challenging by three sample 75 gm oral glucose tolerance test (OGTT) following WHO-2013 criteria in the Endocrinology department of BSMMU. Resistin and insulin were measured from serum samples obtained in fasting state during OGTT. Glucose was measured by the glucose oxidase method, resistin by sandwich ELISA and insulin concentration by chemiluminescent immunoassay method. Equations of homeostatic model assessment (HOMA) were used to calculate indices of insulin resistance (HOMA-IR), β-cell function (HOMA-B) and insulin sensitivity (HOMA-%S).

Results: BMI (27.24(±4.27) vs. 25.80±4.19 kg/m², mean±SD; p=0.03), gravida (primi Vs multigravida; p=0.041), history of GDM in previous pregnancy (16% vs 1.2%; p=0.016), family history of diabetes in 1st-degree relatives (53.1% vs. 39.5%; p=0.03) were significantly higher in GDM than in NGT group. Resistin level was significantly higher in GDM [Median(IQR); (13.2(9.85, 16.0) vs 4.66(3.53, 5.96); p=<0.001; GDM vs NGT]. In a binary logistic regression model adjusted for HOMA-IR, previous history of GDM, BMI, and parity, resistin was observed to be an independent predictor of GDM (B=1.177, 95%CI=1.105-1.252, p=<0.001). ROC curve analysis for the prediction of GDM by resistin showed an AUC of 0.856 (p=<0.001).

Conclusions: Resistin level is significantly higher in GDM mothers. But no significant difference in resistin was noted across different trimesters in both GDM as well as NGT groups.

Keywords: Gestational diabetes mellitus, Resistin, insulin resistance