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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EGestational diabetes mellitus (GDM) can lead to short- and long-term health risks for both the mother and the infant, including increased risk of type 2 diabetes later in life. This article presents results of a retrospective study that aimed to determine whether an elevated serum ferritin level during the first trimester is associated with subsequent GDM when there is no evidence of inflammation.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Enutrition clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ematernal nutrition\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epregnancy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes mellitus\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EGestational diabetes mellitus (GDM) can lead to short- and long-term health risks for both the mother and the infant, including increased risk of type 2 diabetes later in life. Recent evidence shows that excess iron stores are associated with an increased risk of diabetes. Moderately elevated ferritin levels, though well below those observed in iron overload disorders, have been associated with increased insulin secretion, decreased insulin sensitivity, and type 2 diabetes. However, the level of elevation at which this increased risk begins has not been established.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EThe proposed mechanisms for the association of an elevated ferritin level with increased diabetes risk include excess iron and inflammation. A randomized controlled trial in nonanemic pregnant women revealed that daily iron supplementation increased ferritin levels but did not increase the risk of GDM [Chan KKL et al. \u003Cem\u003EBJOG\u003C\/em\u003E 2009]. Case-control studies that looked at the association of GDM in pregnant women and high ferritin levels have not indicated a clear association after controlling for inflammation [Sharifi F et al. Diabetes Metab Syndr Obes 2010; Chen X et al. Diabetes Care 2006]. Amina Khambalia, PhD, University of Sydney, Sydney, Australia, presented results of a retrospective study that aimed to determine whether an elevated serum ferritin level during the first trimester is associated with subsequent GDM when there is no evidence of inflammation.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EPatients in the first trimester of pregnancy (n = 3143) had clinical and laboratory data collected. Women with preexisting diabetes, multiple pregnancies, or C-reactive protein (CRP) \u0026gt;5 mg\/L were excluded. Stored blood samples were tested for serum ferritin, soluble transferrin receptor (sTfR), and CRP. Birth data and hospital data records on GDM were linked for the remaining 3045 pregnancies. Among these, 3.6% (n = 110) developed GDM.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EThe development of GDM was associated with maternal age \u226535 years (p \u0026lt;.004), gestational age \u0026gt;12 weeks (p = .06), weight \u2265 75th percentile (p = .05), and geography (p = .002). On univariate analysis, median ferritin levels were significantly higher among women with GDM (33.9 \u03bcg\/L) compared with women without GDM (25.9 \u03bcg\/L; p = .0007; \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). There was no significant difference in sTfR levels between the 2 groups. Fewer women with GDM were iron deficient (7.4%) compared with women without GDM (18.8%; p = .005). Women with GDM were more likely to have ferritin levels in the highest tertile (46.3% vs 32.6%; p = .005) and 75th percentile (33.7% vs 24.7%; p = .05) when compared to women without GDM.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16454\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16454\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16454\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EUnivariate Analysis of Iron Status in Women With and Without GDM\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EMultivariate analysis adjusting for maternal age, parity, country of birth, weight, gestational age at blood collection, smoking, and CRP, revealed that ferritin was still associated with a statistically significant increased risk of developing GDM (adjusted odds ratio, 1.44; 95% CI, 1.10 to 1.90).\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EThese results showed evidence of an association between elevated ferritin level and risk of developing GDM among women without evidence of inflammation. Transferrin receptor levels were not associated with the development of GDM. Future studies are needed to confirm these results, to determine if there is utility in the routine measurement of ferritin, and to identify other markers of iron and inflammation.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/5\/11.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzon6r\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzon6r\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}