Ghrelin in Serum and Urine of Post-Partum Women with Gestational Diabetes Mellitus

Abstract

Women with a previous history of gestational diabetes mellitus (GDM) have a significantly increased risk of developing type 2 diabetes, obesity, and cardiovascular diseases in the future. The aim of the study was to evaluate ghrelin concentrations in serum and urine in the GDM group in the early post-partum period, with reference to laboratory results, body composition, and hydration status. The study subjects were divided into two groups, that is, 28 healthy controls and 26 patients with diagnosed GDM. The maternal body composition and hydration status were evaluated by the bioelectrical impedance analysis (BIA) method. The concentrations of ghrelin in the maternal serum and urine were determined via enzyme-linked immunosorbent assay (ELISA). The laboratory and BIA results of the mothers with GDM were different from those without GDM. Urine ghrelin positively correlated with serum ghrelin and high-density lipoprotein cholesterol (HDL) levels in healthy mothers. There were direct correlations between urine ghrelin and HDL as well as triglycerides levels in the GDM group. Neither the lean tissue index nor body cell mass index were related to the serum ghrelin concentrations in this group. Only the urine ghrelin of healthy mothers correlated with the fat tissue index. Our results draw attention to urine as an easily available and appropriable biological material for further studies.

Fatty Acid-Binding Protein 4—An “Inauspicious” Adipokine—In Serum and Urine of Post-Partum Women with Excessive Gestational Weight Gain and Gestational Diabetes Mellitus

“…In our study positive correlations were found between the serum FABP4 and urine ghrelin as well as between the urine FABP4 and serum ghrelin levels in the EGWG group and also between the urine FABP4 and ghrelin levels in the GDM group. Our previous study showed that women with GDM had lower serum and higher urine ghrelin concentrations in the early post-partum period in comparison with the healthy controls, i.e., at 48 h after delivery, yet, these differences were statistically insignificant [2]. On the other hand, there was a positive correlation between the serum and urine ghrelin levels, but only in the healthy mothers.…”

“…It seems that this irrelevant difference in favour of greater ghrelin levels in urine might be caused by disturbed metabolism of the circulating ghrelin in GDM mothers. This might have resulted from increased renal ghrelin clearance [2]. Zhang et al demonstrated that overexpression of ghrelin gene via the FABP4 promoter exhibits high plasma concentration of des-acyl ghrelin, alters the development of the white adipose tissues, and improves glucose tolerance and insulin sensitivity [46].…”

“…Very few studies concerning BIA in the assessment of GDM have been reported so far. Our previous study showed that mothers with GDM in the early puerperium, when compared with the healthy controls, presented higher levels of not only FTI, which is defined as the adipose tissue mass divided by the square of the body height and is expressed in units of kg/m 2 , but also of TBW and ECW, where the latter consists of the interstitial water, plasma water, and transcellular water [2].…”

“…According to the current state of scientific knowledge, pre-pregnancy obesity and excessive gestational weight gain (EGWG) as well as gestational diabetes mellitus (GDM) have been regarded as independent risk factors for post-partum complications in both mothers and their children, which will subsequently lead to an increased risk of chronic diseases later in their lives [1,2,3,4,5]. It has been observed that women with a previous history of GDM and EGWG are much more prone to suffer from type 2 diabetes mellitus (T2DM), obesity, cardiovascular diseases (CVDs), and metabolic syndrome in the future [1,2,3,4,5].…”

Umbilical Cord SFRP5 Levels of Term Newborns in Relation to Normal and Excessive Gestational Weight Gain

“…It seems that in many ways the pregnancies of women with EGWG resemble pregnancies complicated by gestational diabetes mellitus (GDM). What is important in this context is that the women with a history of GDM exhibit altered risk factors of cardiovascular diseases, including lower HDL concentrations, when compared with mothers with healthy pregnancies [34,35,36].…”