Gebelikte Rutin Demir Takviyesinin Bozulmuş Glukoz Toleransı Gelişme Riskine Bir Etkisi Var Mıdır?

Amaç: Gestasyonel diabetes mellitus GDM , kötü gebelik sonuçları ve maternal ve fetal mortalite ile ilişkili ciddi bir metabolik bozukluktur. Bozulmuş glikoz toleransı BGT de kötü gebelik sonuçlarını öngören önemli bir parametredir. Çalışmamızın amacı demir, demir bağlama kapasitesi DBK , hb ve ferritin seviyeleri ile BGT arasındaki ilişkiyi ortaya koymaktır.Gereç ve Yöntemler: Bu retrospektif çalışma Dr Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi’ne başvuran, ilk antenatal takiplerine 6-11 haftalar arasında gelen ve 24-28 haftalar arasında 2 basamaklı OGTT uygulanan toplam 100 hasta ile yapılmıştır BGT:50 hasta, Normal OGTT:50 hasta . İlk trimester hemoglobin hb , ferritin, demir, demir bağlama kapasitesi DBK ve OGTT sonuçları iki grup arasında karşılaştırılmıştır.Bulgular: Demir, DBK ve ferritin seviyeleri iki grup arasında istatistiksel olarak farklı bulunmamıştır P

Anahtar Kelimeler:

Gestasyonel diyabet, bozulmuş glukoz toleransı, ferritin, hemoglobin

Is There A Risk For Developing Impaired Glucose Tolerance In The Pregnancy With Routine Iron Supplementation?

Aim: Gestational diabetes mellitus GDM is one of the most important metabolic disorder associated with adverse pregnancy outcome and maternal- fetal mortality and morbidity. Impaired glucose tolerance IGT is also a predictor for poor pregnancy outcome. The aim of the study is to demonstrate the correlation between iron, iron binding capacity IBC , hemoglobin Hb and ferritin levels and IGT.Material And Methods: This retrospective study was performed among 100 patients IGT group:50, Normal OGTT group:50 who were admitted to University of Health Sciences Dr. Zekai Tahir Burak Woman's Health, Education and Research Hospital, attended to the first antenatal visit at 6-11 weeks of gestation, and were applied with two step OGTT between 24-28 weeks of gestation. First trimester serum Hb, ferritin, iron, IBC and OGTT results have been evaluated and compared between two groups.Results: The serum levels of iron, IBC and ferritin have found no significantly different between two groups P

Keywords:

Gestational diabetes, impaired glucose tolerance, ferritin, hemoglobin,

PDF

___

American Diabetes A. Standards of medical care in diabetes--2010. Dia- betes Care. 2010;33 Suppl 1:S11-61.
Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care. 2007;30 Suppl 2:S141-6.
Catalano PM, Ehrenberg HM. The short- and long-term implica- tions of maternal obesity on the mother and her offspring. BJOG. 2006;113(10):1126-33.
Cheng YW, Block-Kurbisch I, Caughey AB. Carpenter-Coustan criteria compared with the national diabetes data group thresholds for gestational diabetes mellitus. Obstet Gynecol. 2009;114(2 Pt 1):326-32.
Malcolm J. Through the looking glass: gestational diabetes as a predic- tor of maternal and offspring long-term health. Diabetes Metab Res Rev. 2012;28(4):307-11.
Group NDD. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979;28(12):1039-57.
Organization WH. Diabetes mellitus, report of a WHO Study Group. Gene- va: WHO 1985. World Health Orgnization, Technical report series. (727).
Sermer M, Naylor CD, Gare DJ, Kenshole AB, Ritchie J, Farine D, et al. Impact of increasing carbohydrate intolerance on maternal-fetal outco- mes in 3637 women without gestational diabetes: the Toronto Tri-Hospital Gestational Diabetes Project. Am J Obstet Gynecol 1995;173(1):146-56.
Santaguida PL, Balion C, Hunt D, Morrison K, Gerstein H, Raina P, et al. Di- agnosis, prognosis, and treatment of impaired glucose tolerance and im- paired fasting glucose. Evid Rep Technol Assess (Summ). 2005;128(1).
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabe- tes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15(7):539-53.
Tiwary GS, Bharadwaj MK, Biswas M, Dey M. Evaluation of the incidence and outcome of gestational diabetes mellitus using the current internatio- nal consensus guidelines for diagnosing hyperglycaemia in pregnancy. J Reprod Contracept Obstet Gynecol 2017;5(3):663-8.
Goonewardene M, Shehata M, Hamad A. Anaemia in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2012;26(1):3-24.
Pavord S, Myers B, Robinson S, Allard S, Strong J, Oppenheimer C, et al. UK guidelines on the management of iron deficiency in pregnancy. Br J Haematol. 2012;156(5):588-600.
Annamraju H, Pavord S. Anaemia in pregnancy. Br J Hosp Med (Lond). 2016;77(10):584-8.
Scholl TO, Hediger ML, Fischer RL, Shearer JW. Anemia vs iron deficien- cy: increased risk of preterm delivery in a prospective study. Am J Clin Nutr 1992;55(5):985-8.
Guidotti R. Anaemia in pregnancy in developing countries. BJOG: Int J Obstet Gynecol 2000;107(4):437-8.
Viteri FE. The consequences of iron deficiency and anemia in pregnancy. Nutrient regulation during pregnancy, lactation, and infant growth: Sprin- ger; 1994. p. 127-39.
Kataria Y, Wu Y, Horskjaer PH, Mandrup-Poulsen T, Ellervik C. Iron Status and Gestational Diabetes-A Meta-Analysis. Nutrients. 2018;10(5).
Javadian P, Alimohamadi S, Gharedaghi MH, Hantoushzadeh S. Gestati- onal diabetes mellitus and iron supplement; effects on pregnancy outco- me. Acta Med Iran. 2014;52(5):385-9.
Abu-Ouf NM, Jan MM. The impact of maternal iron deficiency and iron deficiency anemia on child's health. Saudi Med J. 2015;36(2):146-9.
McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide pre- valence of anaemia, WHO Vitamin and Mineral Nutrition Information Sys- tem, 1993-2005. Public Health Nutr. 2009;12(4):444-54.
Zhang C, Rawal S. Dietary iron intake, iron status, and gestational diabe- tes. Am J Clin Nutr. 2017;106(Suppl 6):1672S-80S.
Lachili B, Hininger I, Faure H, Arnaud J, Richard M-J, Favier A, et al. Increased lipid peroxidation in pregnant women after iron and vitamin C supplementation. Biol Trace Elem Res 2001;83(2):103-10.
DeFronzo RA. The triumvirate: β-cell, muscle, liver: a collusion respon- sible for NIDDM. Diabetes. 1988;37(6):667-87.
Kataria Y, Wu Y, Horskjær PdH, Mandrup-Poulsen T, Ellervik C. Iron Status and Gestational Diabetes—A Meta-Analysis. Nutrients. 2018;10(5):621.
Cooksey RC, Jones D, Gabrielsen S, Huang J, Simcox JA, Luo B, et al. Dietary iron restriction or iron chelation protects from diabetes and loss of β-cell function in the obese (ob/ob lep−/−) mouse. Am J Physiol Endocrinol Metab 2010;298(6):E1236-E43.
Rajpathak SN, Crandall JP, Wylie-Rosett J, Kabat GC, Rohan TE, Hu FB. The role of iron in type 2 diabetes in humans. Biochim Biophys Acta Gen Subj 2009;1790(7):671-81.
Lao TT, Tam K-FF. Maternal serum ferritin and gestational impaired gluco- se tolerance. Diabetes Care. 1997;20(9):1368-9.
Fernandez-Cao JC, Aranda N, Ribot B, Tous M, Arija V. Elevated iron sta- tus and risk of gestational diabetes mellitus: A systematic review and meta-analysis. Matern Child Nutr. 2017;13(4).
Fu S, Li F, Zhou J, Liu Z. The Relationship Between Body Iron Status, Iron Intake And Gestational Diabetes: A Systematic Review and Meta-Analy- sis. Medicine (Baltimore). 2016;95(2):e2383.
Li X, Lu X. Study on correlation between C-reactive protein and gestatio- nal diabetes mellitus. JNMU 2007;21(6):382-5.
Derbent AU, Simavli SA, Kaygusuz I, Gumus II, Yılmaz S, Yıldırım M, et al. Serum hepcidin is associated with parameters of glucose metabolism in women with gestational diabetes mellitus. J Matern Fetal Neonatal Med 2013;26(11):1112-5.
Amiri FN, Basirat Z, Omidvar S, Sharbatdaran M, Tilaki KH, Pouramir M. Comparison of the serum iron, ferritin levels and total iron-binding capa- city between pregnant women with and without gestational diabetes. J Nat Sci Biol Med 2013;4(2):302.