Gestasyonel Diyabetik ve Nondiyabetik Gebelerin Glukoz, Lipid, Krom Seviyelerinin Sağlıklı Gruplara Göre Değişimlerinin İncelenmesi

Öz Amaç: Bu çalışmada, gestasyonel diyabet tanısı almış ve diyabetli olmayan gebeler ile aynı yaş grubunda gebe olmayan sağlıklı kadın bireylerin Açlık Kan Şekeri (AKŞ), total kolesterol, trigliserit, ve plazma krom (Cr) parametreleri çalışılarak, bu metabolik parametrelerin, gebelik ile gestasyonel diyabetteki değişimleri ve birbirleri ile etkileşimlerinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmaya, 50 adet gestasyonel diyabetli(GDM) gebe, 50 adet diyabetli olmayan sağlıklı gebe ile 50 adet aynı yaş grubunda olan gebe olmayan sağlıklı kadın birey dahil edilmiştir. Hasta ve kontrol grubundan alınan kan örneklerinde AKŞ, total kolesterol, trigliserit ve plazma Cr konsantrasyonları ölçülmüştür. Bulgular: GDM’li grubun AKŞ ve plazma Cr düzeyleri, diğer iki gruptan anlamlı yüksek çıkmıştır(p<0.05). GDM’li grubun total kolesterol ve trigliserit düzeyleri kontrol grubuna göre anlamlı yüksek çıkarken(p<0.05), nondiyabetik gruptan anlamlı bir fark bulunmamıştır. Nondiyabetik gebe grubun trigliserit ve plazma Cr düzeyleri, kontrol grubuna göre yüksek bulunmuştur(p<0.05). Buna ek olarak tüm grupların plazma Cr düzeyleri; vücut kitle indeksi (VKİ), total kolesterol ve trigliserit düzeyleri ile pozitif korelasyon göstermektedir. Sonuçlar: Bu çalışmada GDM’li hastalarda krom düzeyleri diğer iki gruba göre anlamlı olarak yüksek bulunmuştur. Plazma krom ile VKİ, trigliserit ve total kolesterol düzeyleri arasında pozitif korelasyon saptanmıştır. Krom ve diyabetin tüm türleri ile ilgili oldukça çelişkili yayınlar vardır, gelecekteki araştırmaların dokuda krom düzeyini de kapsayacak biçimde, diyabetteki rolü üzerine olacağı görülmektedir.

Anahtar Kelimeler:

Gestasyonel Diyabetes Mellitus, Krom, Glukoz, Total Kolesterol, Trigliserit

Investigation of Glucose, Lipid, Chromium Level Changes in Gestational Diabetic and Nondiabetic Pregnants Compared with Healthy Groups

Aim: In this study, it is aimed to investigate the changes and interactions of these metabolic parameters inpregnancy and gestational diabetes and by studying fasting blood sugar, total cholesterol, triglyceride and plasmachromium parameters, in blood samples of pregnant women diagnosed with gestational diabetes, pregnantwomen without diabetes and healthy women who are not pregnant in the same age groupMaterials and Methods: This study included 50 pregnant women with gestational diabetes, 50 healthy pregnantwomen without diabetes and 50 healthy non-pregnant women in the same age group. It was measured fastingblood sugar, total cholesterol, triglyceride and plasma chromium concentrations in blood samples taken from thepatient and control groupsResults: Fasting blood sugar and plasma chromium levels of gestational diabetes group were significantly higherthan the other two groups (p <0.05). While the total cholesterol and triglyceride levels of the gestational diabetesgroup were significantly higher than the control group (p <0.05), there was no significant difference from the non-diabetic group. Triglyceride and plasma chromium levels of non-diabetic pregnant group were higher thanthe control group (p <0.05). Plasma chromium levels shows a positive correlation with Body mass index, totalcholesterol and triglyceride levels of all groups.Conclusion: In this study, chromium levels in gestational diabetes mellitus patients were found to besignificantly higher than the other two groups. A positive correlation was found between plasma chromium andBody mass index, triglyceride and total cholesterol levels. There are quite contradictory publications on all typesof diabetes and chromium. It seems to be on his role in diabetes, to include the level of chromium in the tissue offuture research.

Keywords:

Gestational Diabetes Mellitus, Glucose, Chrome, Total Cholesterol, Triglycerides,

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1. Turok, D, K, Ratcliffe, S, D, Baxley, E, G, Management of gestational diabetes mellitus, American Family Physician, 2003, 68, 1767-1772.
2. Harris, S, B, Caulfield, L, E, Sugamori, M, E, Whalen, E, A, Henning, B, The epidemiology of diabetes in pregnant native canadians. a risk profile, Diabetes Care, 1997, 20, 1422-1427.
3. Mazze, R, S, Krogh, C, L, Gestational diabetes mellitus: Now is the time for detection and treatment, Mayo Clinic Proceedings, 1992, 67, 995-1002.
4. Langer, O, Yogev, Y, Most, O, Xenakis, E, M, Gestational diabetes: The consequences of not treating. American Journal Of Obstetrics & Gynecology, 2005,192, 989-997.
5. Fan, Z, T, Yang, H, X, Gao, X, L, Lintu, H, Sun, W, J, Pregnancy outcome in gestational diabetes, International Journal Of Gynecology & Obstetrics, 2006, 94, 12-18.
6. Moore, P, Kolterman, O, Weyant, J, Olefsky, J, M, Insulin binding in human pregnancy: comparisons to the postpartum, luteal, and follicular states. The Journal Of Clinical Endocrinology & Metabolism, 1981, 52, 937-941.
7. Menato, G, Bo, S, Signorile, A, Current management of gestational diabetes mellitus, Expert Review Of Obstetrics & Gynecology, 2008, 3, 73-91.
8. Takiishi, T, Gysemans, C, Bouillon, R, Mathieu, C, Vitamin D and diabetes. Endocrinology and Metabolism Clinics Of North America, 2010, 39, 419-446.
9. Silverman, B, L, Rizzo, T, Cho, N, H, Metzger, B, E, Long-term effects of the intrauterine environment, The Northwestern University Diabetes İn Pregnancy Center Diabetes Care, 1998, 21 Suppl 2, 142-151.
10. Knowler, W, C, Barrett, Connor, E, Fowler, S, E, Hamman, R, F, Lachin, J, M, Walker, E, A, Nathan, D, M, Diabetes prevention program research g. reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin, New England Journal Of Medicine, 2002, 346, 393-403.
11. Lewicki, S, Zdanowski, R, Krzyzowska, M, Lewicka, A, Debski, B, Niemcewicz, M, et al, The role of chromium III in the organism and its possible use in diabetes and obesity treatment, Ann Agrienv Medicine, 2014, 2, 331–335.
12. Davidson, I, Burt, R, Physiologic changes in plazma chromium of normal and pregnant women: Effect of a glucose load, American Journal of Obstetrics and Gynecology, 1973, 116, 601– 608.
13. Morris, B, W, Samaniego, S, Fraser, R, Macneil S, Increased chromium excretion in pregnancy is associated with insulin resistance, The Journal of Trace Elements in Experimental Medicine, 2000, 13, 389 –396.
14. Cosson, E, Benchimol, M, Carbillon, L, Universal rather than selective screening for gestational diabetes mellitus may improve fetal outcomes, Diabetes & Metabolism, 2006, 32, 140-146.
15. Griffin, M, E, Coffey, M, Johnson, H, Universal risk factor-based screening for gestational diabetes mellitus: Detection rates, gestation at diagnosis and outcome, Diabetic Medicine, 2000, 17, 26-32.
16. Rey, E, Hudon, L, Michon, N, Fasting plazma glucose versus glucose challenge test: screening for gestational diabetes and cost effectiveness, Clinical Biochemistry, 2004, 37, 780-784.
17. Czok, R, Barthelmai, W, Enzymatische bestimmungen der glucose in blut, Wiener Klinische Wochenschrift, 1962, 40, 585-589.
18. Norbert, W, Tietz clinical guide to laboratory tests second edition, Saunders Philadelphia USA, 1991.
19. Je, S, American Association for Clinical Chemistry Meeting Abstract, 34. Clinical Chemistry And Laboratory Medicine, 1993, 39, 1127.
20. Davis, C, M, Vincent, J, B, Isolation and characterization of a biologically active chromium oligopeptide from bovine liver, Archives of Biochemistry and Biophysics, 1997, 339, 335–343
21. Swaroop, A, Bagchi, M, Preuss, H, G, Zafra-Stone, S, Ahmad, T, Bagchi, D, Benefits of chromium(III) complexes in animal and human health, The Nutritional Biochemistry Of Chromium(III), 2019, 2, 251-278.
22. Kazi, T, G, Afridi, H, I, Kazi, N, Jamali, M, K, Arain, M, B, Jalbani, N, et al, Copper, chromium, manganese, ıron, nickel, and zinc levels in biological samples of diabetes mellitus patients, Biological Trace Element Research, 2008, 122(1), 1–18.
23. Morris B, W, Macneil S, Hardisty C, A, Heller S,, Burgin C, Gray, T, A, Chromium homeostasis in patients with type ıı (nıddm) diabetes Journal of Trace Elements in Medicine and Biology 1999, 13,1–2, 57-61.
24. Costello, R, B, Dwyer, J, T, Bailey R, L, Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness, Nutrition Review, 2016, 74(7), 455–468.
25. Gu, Y, Xu, X, Wang, Z, Xu, Y, Liu, X,, Cao, L, Et al, Chromium-containing traditional chinese medicine, tianmai xiaoke tablet, for newly diagnosed type 2 diabetes mellitus: a meta-analysis and systematic review of randomized clinical trials, Evidence-Based Complementary And Alternative Medicine, 2018, Article ID 3708637, 8 pages
26. Houldsworth, A, Williams, R, Fisher, A, Demaine, A, G, Millward, B, A, Proposed relationships between the degree of ınsulin resistance, serum chromium level/bmı and renal function during pregnancy and the pathogenesis of gestational diabetes mellitus, Internatıonal Journal of Endocrınology and Metabolısm 2017, 3(1)
27. Aharoni, A,, Tesler, B,, Paltieli, Y,, Tal, J,, Dori, Z,, Sharf, M, Hair chromium content of women with gestational diabetes compared with nondiabetic pregnant women, American Journal Of Clinical Nutrition, 1992, 55, 104-107.
28. Ataanya, D, A, Larbie, C, The association between micronutrients levels and gestational diabetes: a cross sectional study in ashanti region International Journal of Biochemistry Research & Review 2018, 24(2), 1-8.
29. Jovanovic, L, Gutierrez, M, Peterson, C, M, Chromium supplementation for women with gestational diabetes mellitus, The Journal Of Trace Elements İn Experimental Medicine, 1999, 12, 91–97.
30. Woods, S, E, Ghodsi, V, Engel, A, Miller, J, James, S, Serum chromium and gestational diabetes Journal of the American Board of Family Medicine, 2008, 21, 153–157.
31. Sundararaman, P, G, Sridhar, G, R, Sujatha, V, Anita, V, Serum chromium levels in gestational diabetes mellitus Indian Journal of Endocrinology and Metabolism, 2012, 16, 70-73.
32. Wilson, J, D, Poster, D, W, Diabetes in williams textbook of endocrinology, 8 Baskı, WB Saunders Company, 1992, 993-1005.
33. Hollngsworth, A, K, Endocrine and metabolic homeostasis in diabetic pregnancy, Clinics İn Perinatology, 1983, 10(3), 593–614
34. Hambıdge, K, M, Droegemueller, W, Changes in plazma and hair concentrations of zinc, copper, chromium and manganase during pregnancy Obsterics and Gynecology, 1974, 44(5) 666-673.
35. Lain, K, Y, Catalano, P, M, Metabolic changes in pregnancy, Clinical Obstet Gynecology, 2007, 50, 938-948.
36. Cefalu, W, T, Hu, F, B, Role of chromium in human health and in diabetes, Diabetes Care, 2004, 27, 2741-2751.
37. Wang Z, Q, Yu Y, Zhang X, Komoroski J, Chromium-insulin reduces insulin clearance and enhances insulin signaling by suppressing hepatic insulin-degrading enzyme andproteasome proteinexpression in kkay mice, Frontiers İn Endocrinology, 2014, 5, 1-6.