Relationship Between Maternal Serum Cortisol and Maternal Insulin Resistance and Fetal Ultrasound Characteristics in Gestational Diabetes Mellitus

Abstract

Introduction Cortisol is proven to play a crucial role in hyperglycemia and fetal development in gestational diabetes mellitus (GDM). This research aims to investigate the relationship between maternal serum cortisol and insulin resistance indices and fetal ultrasound characteristics in women with GDM. Methods A cross-sectional and descriptive study on 144 GDM in Vietnam from January 2015 to December 2020. Serum cortisol was measured using electrochemiluminescence immunoassay at 8 a.m. on the examination day in the vicinity of the 24th gestational week. Fetal ultrasound was performed by an experienced person who was blind to the study. Results The mean cortisol level in the GDM group was 627.04 nmol/L. Serum cortisol levels positively correlated with abdominal circumference (AC), fasting plasma glucose (FPG), insulin, triglycerides, HOMA2-IR, and Mathew indices (with r of 0.18, 0.22, 0.18, 0.17, 0.18, and 0.22, respectively). Serum cortisol levels negatively correlated with QUICKI and McAuley indices (with r of −0.19 and −0.21), respectively. In a univariate linear regression, maternal serum cortisol positively correlated with fetal AC, head circumference (HC), and biparietal diameter (BPD) (with r of 0.21; 0.23; and 0.25, respectively). In a multivariate linear regression analysis, cortisol positively correlated with fetal AC, HC, and BPD after adjusting to maternal McAuley index. Conclusion Serum cortisol levels in GDM correlated with fasting blood glucose, triglycerides, and insulin resistance. Besides, serum cortisol levels in GDM positively correlated with fetal development.

Associations between nutrients in one-carbon metabolism and fetal DNA methylation in pregnancies with or without gestational diabetes mellitus

“…The insulin-like growth factor (IGF) pathway is a major fetal and placental growth-promoting pathway modified by DNA methylation of its components such as IGF2 and IGF binding proteins and is associated with fetal overgrowth in GDM [ 12 , 13 ]. In addition, the hypothalamic–pituitary–adrenal (HPA) axis mediates response to intrauterine stress, including hyperglycemic stress, and has demonstrated either a positive or a negative association with birth weight in different studies [ 14 , 15 ]. Chronic elevation of the effector hormone in this axis, cortisol, is associated with hypertension, type 2 diabetes mellitus, and mental health issues [ 16 ].…”

Gut microbiome is associated with personality traits of free-ranging Tibetan macaques (Macaca thibetana)

“…Studies have shown that hyperglycemic state is closely associated with insulin resistance ( Brown and Goldstein, 2008 ; Huri et al, 2014 ). Insulin resistance is positively correlated with elevated cortisol levels ( Lehrke et al, 2008 ; Nguyen et al, 2023 ), which have been shown to facilitate an increase in aggressive behaviors ( Alink et al, 2008 ; Azurmendi et al, 2016 ). This could be a significant contributing factor to the more frequent aggressive behavior observed in the boldness group of Tibetan macaques.…”

Pregestational Prediabetes Induces Maternal Hypothalamic–Pituitary–Adrenal (HPA) Axis Dysregulation and Results in Adverse Foetal Outcomes

“…However, on day 7, the animals were immediately collected, weighed, and immediately returned to the dams. According to previous studies, day 7 represents a neonatal/newborn development period which loosely correlates with similar developmental stages in humans (summarised in Table 3 [196][197][198]. The animals were kept with their mothers for a period of 21 days/3 weeks under standard laboratory conditions (for temperature and humidity) in a 12 h day and 12 h night cycle.…”