Department of Clinical Laboratory, Medical University of Sofia, Alexander University Hospital, 1431 Sofia, Bulgaria.
Department of Clinical Laboratory, UH St. Ivan Rilski, 1606 Sofia, Bulgaria.
Int J Mol Sci. 2024 Nov 13;25(22):12193. doi: 10.3390/ijms252212193.
Gestational diabetes mellitus (GDM) is considered the most common metabolic disorder of the pregnancy period. It is characterized by pancreatic beta-cell dysfunction in the setting of chronic insulin resistance. Zinc is a nutrient involved in numerous metabolic processes and shows a relationship with glycometabolic disorders and GDM. The latest data have demonstrated the association of zinc with insulin sensitivity and resistance. The exact role of zinc in the connection with indexes of insulin resistance and insulin sensitivity is still not fully clarified. The aim of the study is to analyze the newly calculated indexes Glu/Zn, Ins/Zn, and HOMA-IR/Zn as surrogate markers to explore the correlation between serum zinc status and some indexes of insulin sensitivity and insulin resistance. The possible role of these indexes as markers of insulin resistance in pregnant women was analyzed too. An ROC analysis demonstrated that HOMA-IR/Zn with AUC 0.989, < 0.001 (95% CI 0.967-1.000) and Ins/Zn with AUC 0.947, < 0.001 (95% CI 0.889-1.000) in the GDM group, and only HOMA-IR/Zn index with AUC 0.953, < 0.001 (95% CI 0.877-1.000) in healthy pregnant women, have good power as markers of insulin resistance in both groups. We speculate that these new ratios could be suitable for the assessment of pregnant women at high risk of insulin resistance development and, probably, for the evaluation of the specific pathophysiologic characteristics of women with GDM.
妊娠期糖尿病（GDM）被认为是妊娠期间最常见的代谢紊乱。它的特征是在慢性胰岛素抵抗的情况下胰腺β细胞功能障碍。锌是一种参与多种代谢过程的营养素，与糖代谢紊乱和 GDM 有关。最新数据表明锌与胰岛素敏感性和抵抗有关。锌在与胰岛素抵抗和胰岛素敏感性相关指标的联系中的确切作用尚未完全阐明。本研究旨在分析新计算的 Glu/Zn、Ins/Zn 和 HOMA-IR/Zn 指数作为替代标志物，以探讨血清锌状态与一些胰岛素敏感性和胰岛素抵抗指标的相关性。还分析了这些指数作为孕妇胰岛素抵抗标志物的可能作用。ROC 分析表明，GDM 组中 HOMA-IR/Zn 的 AUC 为 0.989，<0.001（95%CI 0.967-1.000），Ins/Zn 的 AUC 为 0.947，<0.001（95%CI 0.889-1.000），而健康孕妇中仅 HOMA-IR/Zn 指数的 AUC 为 0.953，<0.001（95%CI 0.877-1.000），在两组中均具有良好的胰岛素抵抗标志物效能。我们推测这些新比率可能适合评估有胰岛素抵抗发展高风险的孕妇，并且可能适合评估 GDM 妇女的特定病理生理特征。
