Title:Screening for Gestational Diabetes; Can Apelin Help?
Volume: 20
Issue: 1
Author(s): Dina Akeel Salman, Zina Abdullah Hussein, Taif Eimad and Wassan Nori*
Affiliation:
- Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq
Keywords:
Gestational diabetes, apelin, screening, blood glucose, glycated hemoglobin, body mass index.
Abstract:
Background: Gestational diabetes (GDM) is a pregnancy-related endocrinopathy. Its etiology
is not well understood. Obesity and insulin resistance coexist in GDM. Apelin is an adipocytokine
secreted by fatty cells and expressed in many organs; it can modulate blood glucose. According to research,
apelin levels are higher in obese and type 2 diabetes patients. We aimed to examine the value
of serum apelin as a reliable marker for GDM at 24-28 weeks of pregnancy.
Methods: A case-control study recruited 120 pregnant women in an age range of 20-40 years with a
singleton pregnancy at 24-28 weeks of pregnancy; all were matched in BMI and gestational age. They
are divided into 2 groups: 60/120 GDM cases based on the International Association of Diabetes and
Pregnancy and 60/120 matched controls at a gestational age of 24-28 weeks at Al-Yarmouk Teaching
Hospital. Demographics data, serum biochemical permeates including HbA1c, fasting blood sugar
(FBS), fasting insulin level, 1 h plasma glucose, and 2 h plasma glucose, following a 75-gram glucose
loading, and a fasting insulin level were recorded.
Results: None of the demographic criteria were significant between the two groups at P < 0.05. FBS,
fasting insulin, OGTT-1 and 2 hours, HbA1c, and serum apelin were significantly higher in GDM cases
with P < 0.0001. Pearson's correlations show that Apelin has a statistically significant correlation
with BMI, FBS, fasting insulin, OGTT-1 and 2 hours, and HbA1c, with r = (0.34, 0.71, 0.65, 0.72, and
0.63) and P < 0.0001. ANOVA confirmed an insignificant effect of BMI centile on serum apelin, P <
0.072. ROC estimated the apelin cut-off at > 11.3 (ng/l), associated with 84% sensitivity and 100%
specificity, P < 0.001.
Conclusion: Strong and significant apelin correlations with parameters for screening GDM make it a
valuable marker, especially when its levels are unaffected by body mass index. Further studies are
recommended to unveil therapeutic avenues for apelin.
