Objectives: To evaluate value of sequential estimation of serum levels of tumor necrosis factor-α (TNF-α) and ficolin-3 in pregnant women for early prediction of insulin resistance (IR) and gestational diabetes mellitus (GDM).
Patients & Methods: During follow-up 96 pregnant women developed IR only (Group A), 42 women developed IR that was progressed to GDM (Group B) and 20 women who were free of both IR and GDM were chosen as Control group. All women underwent evaluation and gave blood sample for baseline laboratory investigations and to undertake the 75-Oral glucose tolerance test (75-OGTT) and ELISA estimation of human insulin, TNF-α and ficolin-3. Evaluated clinical variables included Baseline body mass index (BMI), IR that was evaluated using Homeostasis model assessment of insulin resistance (HOMA-IR) score and GDM that was diagnosed according to the results of the 75-OGTT.
Results: Serum levels of TNF-α increased progressively during pregnancy in all women compared to baseline levels and women of groups A and B had significantly higher serum TNF-α levels compared to control women with significantly higher levels in group B than in group A. Serum ficolin-3 was progressively and significantly increased compared to baseline levels. At 6th GW ficolin-3 levels were non-significantly higher in group A while was significantly higher in group B compared to controls with non-significant difference between both groups. At 18th and 30th GW, serum ficolin-3 levels were significantly higher in group B women than in control and group A women. Statistical analyses defined high serum TNF-α level at the 6th GW and high serum ficolin-3 at 18th GW as predictors for development of both IR and GDM.
Conclusion: combined estimation of serum TNF-α and ficolin-3 early in pregnancy could be used as a screening test for pregnant women especially those at high-risk for development of GDM.