Chemokines in Gestational Diabetes Mellitus.

Hongying Liu,Atipatsa C Kaminga,Aizhong Liu,Judy Mcdonald,Shi Wu Wen,Xiongfeng Pan

doi:10.3389/fimmu.2022.705852

Abstract

BackgroundStudies investigating chemokines in gestational diabetes mellitus (GDM) have yielded mixed results. The purpose of this meta-analysis was to explore whether concentrations of chemokines in patients with GDM differed from that of the controls.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched Web of Science, Embase, Cochrane Library, and PubMed databases for articles, published in any language, on chemokines and GDM through August 1st, 2021. The difference in concentrations of chemokines between patients with GDM and controls was determined by a standardized mean difference (SMD) with a 95% confidence interval (CI), calculated in the meta-analysis of the eligible studies using a random-effects model with restricted maximum-likelihood estimator.ResultsSeventeen studies met the inclusion criteria for the meta-analysis. Altogether, they included nine different chemokines comparisons involving 5,158 participants (1,934 GDM patients and 3,224 controls). Results showed a significant increase of these chemokines (CCL2, CXCL1, CXCL8, CXCL9, and CXCL12) in the GDM patients compared with the controls. However, there was a significant decrease of the chemokines, CCL4, CCL11 and CXCL10, in the GDM patients compared with the controls. Moreover, subgroup analysis revealed a potential role of chemokines as biomarkers in relation to laboratory detection (different sample type and assay methods) and clinical characteristics of GDM patients (ethnicity and body mass index).ConclusionGDM is associated with several chemokines (CCL2, CCL4, CCL11, CXCL1, CXCL8, CXCL9, CXCL10 and CXCL12). Therefore, consideration of these chemokines as potential targets or biomarkers in the pathophysiology of GDM development is necessary. Notably, the information of subgroup analysis underscores the importance of exploring putative mechanisms underlying this association, in order to develop new individualized clinical and therapeutic strategies.

Highlights

In recent years, the incidence of gestational diabetes mellitus (GDM) has increased rapidly worldwide and constitutes a major public health problem [1]
Anthropometric and clinical phenomics characteristics of included studies are described in the Appendix 2 and 3, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), 2h Post prandial blood glucose, cholesterol, triglycerides, low-density lipoprotein (LDL)-C, high-density lipoprotein (HDL)-C, Insulin, HOMA-insulin resistance (IR) and hemoglobin A1c (HbA1c)
For CXC chemokines, CXCL1 concentrations were significantly higher in the GDM patients than in the controls (SMD=2.04; 95% confidence intervals (CIs): 1.61; 2.48); CXCL8 concentrations were significantly higher in the GDM patients than in the controls (SMD=1.13; 95% CI: 0.32; 1.94); CXCL9 concentrations were significantly higher in the GDM patients compared with the controls (SMD=8.27; 95% CI: 7.17; 9.36); CXCL10 concentrations were significantly lower in the GDM patients than in the controls (SMD=-1.50; 95% CI: -2.69; -0.32); CXCL12 concentrations were significantly higher in the GDM patients compared with the controls (SMD=4.38; 95% CI: 3.73; 5.04)

Summary

Introduction

The incidence of gestational diabetes mellitus (GDM) has increased rapidly worldwide and constitutes a major public health problem [1]. GDM leads to adverse short-term perinatal complications (e.g., eclampsia, preeclampsia, placental malfunction, diabetic fetopathy, and jaundice, etc.) and longterm metabolic disorders complications (e.g., increased risk of developing hypertension, Type 2 Diabetes Mellitus (T2DM), metabolic syndrome, and atherosclerotic, etc.) in both the offspring and mothers [2–4]. An increasingly compelling body of research evidence has emerged linking low-grade inflammation state to GDM [5]. The immune activation in state of low-grade inflammation is known to decrease b cell function and promote insulin resistance in T2DM [6]. Studies investigating chemokines in gestational diabetes mellitus (GDM) have yielded mixed results. The purpose of this meta-analysis was to explore whether concentrations of chemokines in patients with GDM differed from that of the controls

Objectives

Methods

Results

Conclusion