Zhang Xiaomei, Huo Lili, Yuan Ning, Wang Zhixin, Zhu Xingyun, Zhao Dan, Sun Jianbin
Department of Endocrinology, Peking University International Hospital, Beijing, China.
Department of Endocrinology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
PLoS One. 2025 Jun 13;20(6):e0322719. doi: 10.1371/journal.pone.0322719. eCollection 2025.
Iron is increasingly recognized to influence glucose metabolism. However, evidence about the linkage between body iron stores and the risk of developing gestational diabetes mellitus (GDM) is still inconclusive. We aimed to prospectively investigate the association of serum ferritin concentrations with GDM.
We studied 847 women from Peking University International Hospital from December 2017 to March 2019. Serum ferritin concentrations were measured three times during pregnancy (gestational weeks 6-12, 24-28 and 32-34). GDM was diagnosed by a 75-g oral-glucose-tolerance test (OGTT) at 24-28 weeks' gestation. Logistic regression analyses were carried out to determine the influence of serum ferritin at the first and second trimester on the risk of developing GDM.
Among 847 participants, 73 women (8.6%) developed GDM. The median (IQR) of serum ferritin concentrations were 50.6 (32.4-75.5) ng/mL at gestational weeks 6-12, 19.7 (12.0-28.4) ng/mL at gestational weeks 24-28 and 19.4 (11.4-27.2) ng/mL at gestational weeks 32-34. The median serum ferritin concentrations were all significantly higher in women with GDM than those without GDM at the first, second and third trimester. Ferritin concentrations were positively correlated with the risk of GDM; the adjusted OR (95% CI) for highest vs lowest quartile was 2.97 (1.36, 6.51) at the first trimester and 2.64 (1.26, 5.54) at the second trimester.
Elevated serum ferritin concentrations in the first and second trimester during pregnancy are both independently associated with increased risk of GDM.
铁对葡萄糖代谢的影响日益受到认可。然而，关于机体铁储备与妊娠期糖尿病（GDM）发生风险之间联系的证据仍不确凿。我们旨在前瞻性地研究血清铁蛋白浓度与GDM的关联。
我们对2017年12月至2019年3月期间北京大学国际医院的847名女性进行了研究。在孕期（妊娠6 - 12周、24 - 28周和32 - 34周）对血清铁蛋白浓度进行了三次测量。在妊娠24 - 28周时通过75克口服葡萄糖耐量试验（OGTT）诊断GDM。进行逻辑回归分析以确定孕早期和孕中期血清铁蛋白对发生GDM风险的影响。
在847名参与者中，73名女性（8.6%）发生了GDM。妊娠6 - 12周时血清铁蛋白浓度的中位数（四分位间距）为50.6（32.4 - 75.5）纳克/毫升，妊娠24 - 28周时为19.7（12.0 - 28.4）纳克/毫升，妊娠32 - 34周时为19.4（11.4 - 27.2）纳克/毫升。在孕早期、孕中期和孕晚期，GDM女性的血清铁蛋白浓度中位数均显著高于非GDM女性。铁蛋白浓度与GDM风险呈正相关；孕早期最高四分位数与最低四分位数相比的调整比值比（95%可信区间）为2.97（置信区间为1.36至6.51），孕中期为2.64（1.26至5.54）。
孕期孕早期和孕中期血清铁蛋白浓度升高均与GDM风险增加独立相关。
