ESTIMATED MATERNAL SERUM RESISTIN AND TUMOR NECROSIS FACTOR-Α AT 6th GESTATIONAL WEEK AS EARLY PREDICTORS OF GESTATIONAL INSULIN RESISTANCE
Hany A. El-Kallaf, Adel F. Al-kholy
Departments of Obstetrics & Gynecology & Medical Biochemistry*, Faculty of Medicine, Benha University, Egypt
Objectives: Estimation of serum resistin and TNF-α at time of pregnancy diagnosis and 6th gestational week (GW) to investigate its relation to development of gestational insulin resistance (GIR) and diabetes mellitus (GDM). Patients & Methods: All enrolled pregnant women underwent 75-Oral glucose tolerance test (OGTT) and ELISA estimation of serum resistin and TNF-α at baseline time and at the 6th GW. GIR was diagnosed using the homeostasis model assessment of IR (HOMA-IR) at score of >2 and GDM was diagnosed according to the results of the 75-OGTT if fasting blood glucose (FBG) was ≥92 mg/dl, 1-h postprandial BG (PPBG) ≥180 mg/dl and 2-h BG ≥153 mg/dl. Study outcomes included the frequency of GIR and GDM, changes in serum levels of TNF-α and resistin throughout pregnancy and its relation to frequency and severity of GIR and GDM. Results: At the 30th GW, 112 women (34.9%) were IR and 39 women (12.1%) progressed to GDM. Serum resistin and TNF-α levels were significantly increased at 6th GW than baseline measures in all pregnant women with significant variance among study groups. Statistical analyses defined high baseline serum resistin as significant predictor for development of GIR and the hazard for being IR rises sharply with serum resistin above 5.5 ng/ml and high 6-GW serum TNF-α levels at cutoff points of serum TNF-α 10.79 ng/ml and 15.9 ng/ml as significant early predictors for development of GIR and GDM, respectively. Conclusion: Estimated serum resistin and TNF-α levels were positively associated with the risk for development of GIR and/or GDM later in pregnancy. Baseline serum resistin and 6-GW serum TNF-α levels could differentiate women susceptible to develop GIR and GDM, so could be used as early predictors.