Changes Of Serum Homocysteine Levels In Patients With Gestational Diabetes Mellitus

Abstract

Aim: To investigate homocysteine levels in patients with gestational diabetes, compare with non-diabetic patients and search the potential relation with disease.Material And Methods: Patients whose medical examinations and births were performed in Zekai Tahir Burak Women Health and Research Hospital High Risk Pregnancy Clinic were included to study prospectively.Gestational diabetic patients were enrolled as study group and non-diabetic patients were enrolled as control group.Demographic data of the patients, gestational age at birth, birth type, birthweight of newborns and complications occured during neonatal follow-up were recorded.All patients were scanned for gestational diabetes between 24-28 weeks.Homocysteine levels and -because they are very important for methionine-homocysteine metabolism- folic acid and vit B12 levels were evaluated.Results: When patients with and without GDM were compared, ages of the patients;gravidy-parity and weight gains during pregnancy were significantly higher for patients with GDM p

Keywords

• Gestational diabetes,homocysteine,folic acid

Gestasyonel Diabetli Hastalarda Serum Homosistein Düzeyleri Değişimi

Abstract

Amaç: Bu çalışmanın amacı gestasyonel diabet tanısı almış olan hastalarda maternal homosistein düzeylerinin araştırılması, diabetik olmayan hastalarla karşılaştırılması ve hastalıkla olası ilgisinin değerlendirilmesidir.Gereç ve Yöntemler: Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Yüksek Riskli Gebelikler servisinde takipleri ve doğumu gerçekleştirilen hastalardan, gestasyonel diabet tanısı almış olanlar çalışma grubunu, diabet tanısı olmayan hastalar kontrol grubunu oluşturacak şekilde prospektif olarak toplandı. Hastaların demografik verileri doğum yaptıkları gebelik haftası, doğum şekli, yenidoğanların ağırlığı, neonatal takipte ortaya çıkan özellikler kaydedildi. Tüm gebeler 24-28. gestasyonel haftalar arasında rutin olarak gestasyonel diabet taramasından geçirildi. Homosistein düzeyleri ve metionin-homosistein metabolizmasında çok önemli yer tutmaları nedeniyle hastaların folik asit ve vitB12 düzeyleri ve ayrıca albümin düzeyleri de değerlendirildi.Bulgular: GDM’ si olan ve olmayan hastaların karşılaştırmasında GDM olan hastalarda gravida ve pariteler, hastaların yaşları, ve gebelerin kilo alımı anlamlı olarak daha fazla bulundu p

Keywords

• Gestasyonel diabet,homosistein,folik asit

References

1. Poomalar GK. Changing trends in management of gestational diabetes mellitus. World J Diabetes 2015; 6: 284–295.
2. Sénat MV, Affres H, Letourneau A, Coustols-Valat M, Cazaubiel M, Legar- deur H, Jacquier JF, Bourcigaux N, Simon E, Rod A, Héron I, Castera V, Sentilhes L, Bretelle F, Rolland C, et al. Effect of Glyburide vs Subcutane- ous Insulin on Perinatal Complications Among Women With Gestational Diabetes: A Randomized Clinical Trial. JAMA 2018; 319:1773-1780.
3. Sepe SJ, Channel FA, Geiss LS; Gestational Diabetes incidence Maternal Characteristics and Perinatal Outcome Diabetes (Suppl 2) 34:13 1985.
4. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS; Australian Carbohydrate Intolerance Study in Pregnant Women Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352 (24):2477-2486.
5. Chen L, Wang B, Wang J, Ban Q, Wu H et al. Association between serum total homocysteine and arterial stiffness in adults: a community-based study. J Clin Hypertens. 2018; 20:686-93.
6. Walker M, Smith GN, Perkins S, Keely E, Garner PR. Changes in ho- mocysteine levels during normal pregnancy. Am J Obstet Gynecol 1999;180:660-664.
7. Alatab S, Fakhrzadeh H, Sharifi F, et al. Correlation of serum homocystei- ne and previous history of gestational diabetes mellitus. J Diabetes Metab Disord 2013; 12: 34.
8. Huang T, Ren J, Huang J, et al. Association of homocysteine with type 2 diabetes: a meta-analysis implementing Mendelian randomization appro- ach. BMC Genom 2013; 14: 867.

9. Mazza A, Bossone E, Mazza F, et al. Reduced serum homocysteine levels in type 2 diabetes. Nutr Metab Cardiovasc Dis 2005; 15: 118–124.
10. Herrmann W. The importance of hyperhomocysteinemia as a risk factor- for diseases: An overview. Clin Chem Lab Med 2001;39:666-674.
11. Mascarenhas M, Habeebullah S, Sridhar MG. Revisiting the role of first trimester homocysteine as an index of maternal and fetal outcome. J Pregnancy 2014; art. no.123024
12. Seghieri G, Bresci MC, Anichini R, De Bellis A, Alviggi L, Maida I, Franconi F. Serum homocysteine levels are increased in women with gestational diabetes mellitus. Metabolism 2003;52:720-723.
13. Vitoratos N, Kassanos D, Salamalekis e, Sırısratidis CH, Baimacou E, Cre- atsas G. Maternal homocysteine levels and plasma lipids in gestational diabetes: is there any relationship? J Obstet Gynecol 2002;22:366-369.
14. Kaplan J, Iqbal S, England BG, Zawcki CH, Herman WH. Is pregnan- cy in diabetic women associated with folate defiency? Daibetes Care 1999;22:1017-1021.
15. Mascarenhas M, Habeebullah S, Sridhar MG. Revisiting the role of first trimester homocysteine as an index of maternal and fetal outcome. J Pregnancy. 2014;2014:123024.
16. Tarım E, Bağış T, Kılıçdağ E, Erkanlı S, Aslan E, Sezgin N, Kuşcu E. Ele- vated plasma homocysteine levels in gestational diabetes mellitus. Acta Obstet Gynecol Scand 2004;83:543-547.