The Value of Total antioxidant Status and Serum Tumor Necrosis Factor-α Levels at 24–28 Weeks of Gestation in the Prediction of Optimal Treatment Protocol in Gestational Diabetes Mellitus

S. Ozler; E. Oztas; D. Uygur; A. O. Ersoy; M. Ergin; C. Koca; N. Danisman; S. Erkaya

doi:10.1055/s-0035-1554623

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2019; 127(07): 485-491
DOI: 10.1055/s-0035-1554623

Article

The Value of Total antioxidant Status and Serum Tumor Necrosis Factor-α Levels at 24–28 Weeks of Gestation in the Prediction of Optimal Treatment Protocol in Gestational Diabetes Mellitus

S. Ozler

¹Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey

,

E. Oztas

¹Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey

,

D. Uygur

¹Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey

,

A. O. Ersoy

¹Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey

,

M. Ergin

²Department of Clinical Biochemistry, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey

,

C. Koca

²Department of Clinical Biochemistry, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey

,

N. Danisman

¹Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey

,

S. Erkaya

¹Department of Obstetrics and Gynecology, Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey

› Author Affiliations

Abstract

Aim: The aim of this study was to investigate the serum oxidative stress markers, antioxidant enzyme and tumor necrosis factor-α (TNF-α) levels at 24–28 weeks of gestation and to evaluate the predictive value of them on the subsequent treatment protocol in gestational diabetes mellitus (GDM).

Methods: A total of 58 GDM patients (30 treated with only conventional healthy dietary recommendation (CHDR), 28 treated with insulin) and 30 healthy pregnant women at 24–28 weeks of gestation, were enrolled in this prospective case-control study. The oxidative status, antioxidant enzyme and TNF-α levels were evaluated to determine if there is an association with the need of insulin therapy for glycemic control by using multivariable logistic regression analysis.

Results: TNF-α (OR=11.976, 95%CI: 2.441–58.754, P=0.002) and total antioxidant status (TAS) (OR=12.769, 95%CI: 2.464–66.182, P=0.002) were found to be predictive for GDM at 24–28 weeks of gestation. Besides, further evaluation considering the treatment modality showed that increased TNF-α (OR=18.615, 95%CI: 2.338–148.240, P=0.006) and lower TAS levels (OR=99.471, 95%CI: 2.865–3 453.061, P=0.011) were independent predictors of the need for insulin treatment in GDM patients.

Conclusions: Increased TNF-α levels and low TAS are significantly associated with the increased risk of insulin requirement for achieving good glycemic control in GDM.

Key words

gestational diabetes mellitus - insulin requirement - oxidative stress - tumor necrosis factor-α

Full Text

References

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