Journal article
A longitudinal study of iron status during pregnancy and the risk of gestational diabetes: findings from a prospective, multiracial cohort
Diabetologia, Vol.60(2), pp.249-257
02/2017
DOI: 10.1007/s00125-016-4149-3
PMCID: PMC6331052
PMID: 27830277
Abstract
The aim of this study was to prospectively and longitudinally investigate maternal iron status during early to mid-pregnancy, and subsequent risk of gestational diabetes mellitus (GDM), using a comprehensive panel of conventional and novel iron biomarkers.
A case-control study of 107 women with GDM and 214 controls (matched on age, race/ethnicity and gestational week during blood collection) was conducted within the the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort (2009-2013), a prospective and multiracial pregnancy cohort. Plasma hepcidin, ferritin and soluble transferrin receptor (sTfR) were measured and sTfR:ferritin ratio was derived, twice before GDM diagnosis (gestational weeks 10-14 and 15-26) and at weeks 23-31 and 33-39. GDM diagnosis was ascertained from medical records. Adjusted ORs (aORs) for GDM were estimated using conditional logistic regression analysis, adjusting for demographics, prepregnancy BMI and other major risk factors.
Hepcidin concentrations during weeks 15-26 were 16% higher among women with GDM vs controls (median 6.4 vs 5.5 ng/ml; p = 0.02 ), and were positively associated with GDM risk; the aOR (95% CI) for highest vs lowest quartile was 2.61 (1.07, 6.36). Ferritin levels were also positively associated with GDM risk; the aOR (95% CI) for highest vs lowest quartile was 2.43 (1.12, 5.28) at weeks 10-14 and 3.95 (1.38, 11.30) at weeks 15-26. The sTfR:ferritin ratio was inversely related to GDM risk; the aOR (95% CI) for highest vs lowest quartile was 0.33 (0.14, 0.80) at weeks 10-14 and 0.15 (0.05, 0.48) at weeks 15-26.
Our findings suggest that elevated iron stores may be involved in the development of GDM from as early as the first trimester. This raises potential concerns for the recommendation of routine iron supplementation among iron-replete pregnant women.
Details
- Title: Subtitle
- A longitudinal study of iron status during pregnancy and the risk of gestational diabetes: findings from a prospective, multiracial cohort
- Creators
- Shristi Rawal - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, MSC 7004, Bethesda, MD, 20817, USAStefanie N Hinkle - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, MSC 7004, Bethesda, MD, 20817, USAWei Bao - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USAYeyi Zhu - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, MSC 7004, Bethesda, MD, 20817, USAJagteshwar Grewal - Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USAPaul S Albert - Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USANatalie L Weir - Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USAMichael Y Tsai - Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USACuilin Zhang - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, MSC 7004, Bethesda, MD, 20817, USA. zhangcu@mail.nih.gov
- Resource Type
- Journal article
- Publication Details
- Diabetologia, Vol.60(2), pp.249-257
- Publisher
- Germany
- DOI
- 10.1007/s00125-016-4149-3
- PMID
- 27830277
- PMCID
- PMC6331052
- ISSN
- 1432-0428
- eISSN
- 1432-0428
- Grant note
- HHSN275200800014C / NICHD NIH HHS HHSN275201000009C / NICHD NIH HHS Z99 HD999999 / Intramural NIH HHS ZIA HD008887-01 / Intramural NIH HHS ZIA HD008852-11 / Intramural NIH HHS HHSN275200800003I / NICHD NIH HHS ZIA HD008889-10 / Intramural NIH HHS ZIA HD008887-10 / Intramural NIH HHS ZIA HD008916-06 / Intramural NIH HHS HHSN275201000001G / NICHD NIH HHS HHSN275200800002I / NICHD NIH HHS HHSN275200800002C / NICHD NIH HHS ARRA NIH HHS ZIA HD008889-08 / Intramural NIH HHS ZIA HD008887-08 / Intramural NIH HHS HHSN275200800012C / NICHD NIH HHS HHSN275200800028C / NICHD NIH HHS HHSN275200800003C / NICHD NIH HHS HHSN275200800013C / NICHD NIH HHS ZIA HD008852-09 / Intramural NIH HHS ZIA HD008916-07 / Intramural NIH HHS HHSN275201000001Z / NICHD NIH HHS Z99 CA999999 / Intramural NIH HHS ZIA HD008887-09 / Intramural NIH HHS ZIA HD008889-09 / Intramural NIH HHS
- Language
- English
- Date published
- 02/2017
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9983995010302771
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