Evaluation of serum antioxidant status and dietary antioxidants in patient with gestational diabetes mellitus

Abstract

Background:Diabetes mellitus is the most common metabolic disease complicating pregnancy which leads to maternal and foetal morbidity. Gestational diabetes mellitus (GDM) is described as glucose intolerance diagnosed during pregnancy. Increased oxidative stress has implicated in diabetic problems. The aim of the current study was to evaluate serum antioxidant status and dietary antioxidants in gestational diabetes mellitus. Material and Methods: The study was conducted in the Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur hospital, Delhi from November 2017 to April 2019. 300 Antenatal women were recruited from the ANC OPD of the Department of Obstetrics and Gynaecology with the period of gestation upto 28 weeks diagnosed with GDM as per DIPSI criteria. Preconceptional dietary intakes of nutrients including antioxidants by using a food frequency questionnaire (FFQ). Unpaired student t test was used to compare serum Total Antioxidant Capacity (TAC) levels; dietary antioxidants i.e. Vitamin E, Zinc, Vitamin C & ß-carotene and mitochondrial DNA copy number between GDM and non GDM women. Logistic regression was used for categorical outcome to find the association of serum TAC levels with risk of GDM. A p value of <0.05 was taken as significant. Software used for statistical analysis was SPSS. Results: This was a case control study conducted among 300 antenatal women presenting to the ANC OPD upto 20-22 weeks were recruited and were subjected to a 75 gram OGTT at their first visit. Those with OGTT ≥140 mg/dl were diagnosed as GDM as per DIPSI guidelines and day matched controls with a OGTT <140mg/dl were recruited as controls. Controls were again subjected to a repeat OGTT at 24 to 28 weeks and the OGTT value ≥140 mg/dl were taken as Gestational diabetes (cases) whereas OGTT value <140mg/dl still remained as controls. The average age of women with GDM in the present study was 28.2 years compared to 24.4 years of women without GDM. Over 40% of women with GDM were of age thirty years and over, while only around 10% of women without GDM fell in this age group. The total antioxidant capacity (TAC) of serum was assessed by double-antibody sandwich enzyme-linked immune-sorbent assay (ELISA) method. Multivariate logistic regression was performed to compare independent variables and other potential risk factors between 2 groups. The results showed that TAC concentration of serum in women with GDM was significantly with in healthy pregnant women. Intakes of vitamin E (18.33±2.00, p<0.001), vitamin C (220.45±3.55, p<0.001) β carotene (912.83±11.17, p<0.001) and zinc (11.63±0.75, p<0.001) were highly significantly with women with GDM as compared to healthy pregnant women. The groups showed significant difference in vitamin C, vitamin E, β-carotene, and zinc (p<0.05). Conclusion: Our findings showed that Preconceptional dietary intake of antioxidants Vitamin E, Vitamin C, Zinc and ß-carotene was significantly less in women with GDM as compared to women without GDM. Antioxidant status could be enhanced by consumption of food rich in antioxidant and high dietary intake of fruit and vegetables and other rich antioxidant sources in GDM, which may be ultimately beneficial in the prevention and management of GDM.