Changes of Serum Sex Hormone-Binding Globulin, Homocysteine, and Hypersensitive CRP Levels during Pregnancy and Their Relationship with Gestational Diabetes Mellitus

Abstract

<b><i>Background:</i></b> Inflammatory response state is related to the pathogenesis of gestational diabetes mellitus (GDM). <b><i>Objective:</i></b> To investigate the changes of serum sex hormone-binding globulin (SHBG), homocysteine (Hcy), and hypersensitive CRP (hs-CRP) levels during pregnancy and their relationship with GDM. <b><i>Methods:</i></b> The nested case-control study method was used. Sixty nonobese single pregnant women diagnosed with GDM were divided into the GDM group (GDM, <i>n</i> = 60), together with another 60 pregnant women with normal glucose tolerance who were matched in the same period and divided into the control group (control, <i>n</i> = 60). The serum Hcy, hs-CRP, and SHBG levels were measured. <b><i>Results:</i></b> The serum levels of Hcy and hs-CRP were significantly higher in the GDM group compared with the control group, and serum levels of SHBG was significantly lower in the GDM group compared with the control group at different stages of pregnancy. The serum levels of Hcy and hs-CRP in pregnant women increased with the increase of gestational age, and serum levels of SHBG decreased with the increase of gestational age. Increased Hcy and hs-CRP levels in the second trimester and decreased SHBG levels in the first trimester were related to GDM. The odds ratio (OR) and 95% confidence interval (CI) were as follows: OR: 4.5, 95% CI: 1.5–13.0; OR: 4.2, 95% CI: 1.5–10.1; and OR: 0.4, 95% CI: 0.3–0.7, respectively. <b><i>Conclusion:</i></b> Increased Hcy and hs-CRP in the second trimester and decreased SHBG in the first trimester were independent predictors of GDM, which provides a new idea for early prevention and treatment of GDM.

Recent progress in metabolic reprogramming in gestational diabetes mellitus: a review

“…Lower SHBG levels in early pregnancy are associated with higher insulin levels, IR, and an increased risk of GDM in mid-pregnancy. Therefore, SHBG can be used to identify high-risk pregnancies in early pregnancy ( 45 , 56 ). Additionally, SHBG expression negatively correlates with GLUT1 and positively correlates with GLUT3 and GLUT4, suggesting SHBG’s involvement in glucose metabolism by regulating multiple GLUTs, binding to sex hormones or other pathways, thereby eliminating IR in GDM ( 57 ).…”

Does Maternal SARS-CoV-2 Infection or SARS-CoV-2 Vaccination Trigger an Inflammatory Response in the Fetus? A Prospective Cohort Study

“…The innate immune system is the first line of defense against infection. Innate immunity recognizes microorganisms or nonmicrobial antigens, like an allergen or a transplanted organ, and can result in an exaggerated inflammatory response [5][6][7][8][9][10][11][12][13][14][15][16]. Interleukin-6 (IL-6) promotes humoral immunity to protect against extracellular pathogens and stimulates the production of acute-phase reactants such as C-reactive protein (CRP) by the liver [8].…”

Mendelian randomization identifies age at menarche as an independent causal effect factor for gestational diabetes mellitus

“…25 Other studies have also linked decreased SHBG levels to higher GDM risk. 26,27 SHBG levels therefore serve as a potential marker to identify women who are at risk for GDM. However, other possible confounding variables, such as prepregnancy body mass index, race/ethnicity and alcohol usage, may influence this connection.…”

“…Observational studies have shown that lower oestradiol levels are associated with a higher risk of GDM 25 . Other studies have also linked decreased SHBG levels to higher GDM risk 26,27 . SHBG levels therefore serve as a potential marker to identify women who are at risk for GDM.…”