Elevated TXNIP and reduced PINK1 in gestational diabetes mellitus: association with dyslipidemia and pregnancy complications.

OBJECTIVES

To investigate the association between thioredoxin-interacting protein (TXNIP), PTEN-induced putative kinase 1 (PINK1) and lipid metabolism in gestational diabetes mellitus (GDM), and to assess their clinical significance.

METHODS

This case-control study included 220 pregnant women (110 with GDM and 110 healthy controls) recruited from 2022 to 2024. Clinical assessments included glucose, lipids, and thyroid function profiles. TXNIP and PINK1 mRNA expression were measured using RT-qPCR. Pregnancy outcomes were documented using standardized clinical protocols.

RESULTS

Compared to controls, GDM patients had significantly higher fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPBG), glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR), along with reduced fasting insulin (FINS). Thyroid function tests showed elevated triiodothyronine (T3), and thyroxine (T4) levels in the GDM group. Lipid profiles revealed increased triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C), and decreased high-density lipoprotein cholesterol (HDL-C). TXNIP expression was significantly elevated, while PINK1 expression was decreased in GDM patients. Correlation analysis indicated strong associations between TXNIP and PINK1 levels with lipid values. GDM was also associated with adverse pregnancy outcomes, including higher rates of cesarean delivery, preterm birth, macrosomia, neonatal hypoglycemia, and lower Apgar scores.

CONCLUSIONS

Dyslipidemia in GDM-characterized by elevated TC, TG, and LDL-C and decreased HDL-C-may be associated with upregulation of TXNIP and downregulation of PINK1. These molecular alterations could contribute to metabolic disturbances and poor pregnancy outcomes. Monitoring lipid profiles alongside TXNIP and PINK1 expression may aid in the clinical management of GDM and its complications.