The Relationship between Iron Markers, Cortisol and Insulin Resistance in Gestational Diabetes Mellitus

Abstract

Background: Gestational diabetes mellitus (GDM) is a significant metabolic disorder occurring during pregnancy, associated with serious maternal and fetal complications if left untreated. The global prevalence of GDM emphasizes the urgent need for research into its pathogenesis and contributing factors, including hormonal changes, insulin resistance, and the role of iron metabolism. Objective: The aim of this study was to investigate the relationship between iron markers (hemoglobin, serum iron, and serum ferritin), cortisol, insulin resistance (measured by HOMA-IR), and the development of GDM in pregnant women between 24 and 28 weeks of gestation. Methods: This analytical cross-sectional study included 150 pregnant women, divided into GDM and non-GDM groups based on oral glucose tolerance test results. Iron markers, cortisol, fasting plasma glucose, insulin, and HOMA-IR levels were measured. Data analysis was performed using SPSS version 25, employing descriptive and inferential statistics, including the Mann-Whitney U test for non-normally distributed variables. Results: Women with GDM exhibited significantly higher mean levels of hemoglobin (12.41±0.68 g/dl), serum iron (19.57±1.14 μmol/L), serum ferritin (25.92±2.58 ng/ml), cortisol (451.32±25.20 nmol/L), fasting plasma glucose (6.83±0.46 mmol/L), insulin (12.50±1.72 μU/mL), and HOMA-IR (3.83±0.78) compared to non-GDM participants (p<0.001 for all comparisons). These findings underscore the pronounced biochemical and hormonal alterations associated with GDM. Conclusion: The study identified a significant association between elevated levels of iron markers, cortisol, and insulin resistance with the development of GDM. These findings suggest that monitoring these parameters during pregnancy could be crucial for the early detection and management of GDM. Individualized iron supplementation strategies may be necessary to prevent iron overload and minimize GDM risk.