Serum Homocysteine Level Might Be a Predictor for Persistence of Abnormal Glucose Tolerance in Gestational Diabetes

Abstract

Background: Increased plasma homocysteine levels are recognized to exert oxidative damage resulting into risk factors for insulin resistance (IR) and vascular disease. Present study was conducted to observe post-partum persistence of abnormal glucose tolerance (AGT) and level of homocysteine after delivery in patient with GDM. Methods: This observational cross-sectional study encompassed 100 subjects (age: 28.58±4.26 years, BMI: 26.7±2.80 Kg/m2; mean±SD) who were diagnosed as GDM during their index pregnancy by any of the internationally acceptable standard criteria. At 6-12 weeks postpartum, each of them underwent anthropometric measurements, 75 gram 2 sample OGTT and measurement of plasma homocysteine level by utilizing the chemiluminescent Immunoassay method. Results: Of the 100 subjects, 32% converted to having AGT during 6 -12 week of post-partum follow up. Statistically significant difference was found in between the AGT and normal glucose tolerance (NGT) groups in circulating concentration of homocysteine (AGT vs NGT: 9.19±1.15 vs. 6.29±1.31 mmol/L; p=<0.001). Mean age and BMI were significantly higher in the AGT group (p<0.05 for both). Independent association was found between each of the variables age, history of macrosomia and higher homocysteine level with AGT in multiple regression analysis. Conclusion: Our study identified persistence of AGT and elevation of homocysteine levels are more prominent in women with GDM in post-partum period.