Fan Xizhenzi, Zhang Pan, Wang Lingli, Song Wenhui, Su Achou, Yu Tianxiao
Research Center for Clinical Medical Sciences, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China.
Department of Clinical Laboratory, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China.
PeerJ. 2025 Feb 17;13:e18965. doi: 10.7717/peerj.18965. eCollection 2025.
Gestational diabetes mellitus (GDM) is any degree of glucose intolerance with onset or first detection during pregnancy, with an inconsistent association with serum ferritin (SF). We aimed to ascertain the relationship between SF and the risk of GDM in mid-pregnancy and provide evidence for implementing clinical individualized and reasonable iron supplementation regimens.
A retrospective study was conducted to investigate 1,052 pregnant women at 24-28 weeks of gestation who were examined in the obstetrics department of The Fourth Hospital of Shijiazhuang from January 2019 to December 2021. Questionnaires were used to obtain the general information. The levels of serum ferritin (SF), serum calcium, glycated haemoglobin (HbA1c) and Oral-Glucose-Tolerance-Test (OGTT) were reviewed. The GDM was diagnosed by glucose tests. Multivariate logistic regression was used to determine the relationship between serum ferritin and GDM.
Compared to the non-GDM group, the GDM group had significantly higher level of SF (13.95 (8.59-23.65) ng/mL 12.11 (7.27-19.86) ng/mL, ( = 0.012)). While SF levels positively correlated with 1-hour plasma glucose levels (PG1H) ( = 0.061, = 0.047), there was a negative correlation between SF and HbA1c levels ( = - 0.078, = 0.011). The risk of GDM with higher levels of SF was increased (1.010 (95% CI [1.001-1.020], = 0.025)). In the univariate logistic regression model, the risk of GDM in pregnant women with high ferritin levels was 1.010 (95% CI [1.001-1.020], = 0.025). After adjustment for age and pre-pregnancy body mass index (BMI), the risk of GDM was significantly increased by 44% and 42% respectively (adjusted odds ratio (AOR) = 1.440, 95% CI [1.025-2.023], = 0.035), AOR = 1.420 (95% CI [1.011-1.995], = 0.043). After multivariate adjustment for age and pre-pregnancy BMI, the results were moderately revised (AOR = 1.427, 95%CI [1.013-2.008], = 0.042).
Elevated SF levels of mid-pregnancy was associated with risk of GDM, which may guide the implementation of pregnancy-specific supplementation to some extent with the support of further clinical trials.
妊娠期糖尿病（GDM）是指在孕期出现或首次检测到的任何程度的葡萄糖不耐受，与血清铁蛋白（SF）的关联并不一致。我们旨在确定孕中期SF与GDM风险之间的关系，并为实施临床个体化和合理的铁补充方案提供依据。
进行一项回顾性研究，调查2019年1月至2021年12月在石家庄市第四医院产科接受检查的1052名妊娠24 - 28周的孕妇。通过问卷调查获取一般信息。回顾血清铁蛋白（SF）、血清钙、糖化血红蛋白（HbA1c）和口服葡萄糖耐量试验（OGTT）水平。通过葡萄糖测试诊断GDM。采用多因素logistic回归确定血清铁蛋白与GDM之间的关系。
与非GDM组相比，GDM组的SF水平显著更高（13.95（8.59 - 23.65）ng/mL对12.11（7.27 - 19.86）ng/mL，P = 0.012）。虽然SF水平与1小时血浆葡萄糖水平（PG1H）呈正相关（r = 0.061，P = 0.047），但SF与HbA1c水平呈负相关（r = - 0.078，P = 0.011）。SF水平较高时GDM风险增加（1.010（95%CI[1.001 - 1.020]，P = 0.025））在单因素logistic回归模型中，铁蛋白水平高的孕妇患GDM的风险为1.010（95%CI[1.001 - 1.020]，P = 0.025）。在调整年龄和孕前体重指数（BMI）后，GDM风险分别显著增加44%和42%（调整后的优势比（AOR）= 1.440，95%CI[1.025 - 2.023]，P = 0.035），AOR = 1.420（95%CI[1.011 - 1.995]，P = 0.043）。在对年龄和孕前BMI进行多因素调整后，结果略有修正（AOR = 1.427，95%CI[1.013 - 2.008]，P = 0.042）。
孕中期SF水平升高与GDM风险相关，这在一定程度上可能指导特定孕期补充方案的实施，有待进一步临床试验支持。
