Investigating How High Ferritin Levels are Associated with Gestational Diabetes

Abstract

Gestational diabetes mellites (GDM) is now a widely recognized condition that affects over 10% of mothers within the United States. The CDC estimates between 2-10% of pregnancies in the US are affected by gestational diabetes every year. Gestational diabetes was discovered over a century ago, and our current understanding has enabled us to determine multiple mechanisms that lead to Gestational diabetes. It is becoming clear that placental hormones are the major contributor toward development of Gestational diabetes. Placental growth hormones have the ability to inhibit insulin receptors as a mechanism for causation of gestational diabetes. However, iron has recently emerged as a potential contributor to the development of gestational diabetes. The focus of my thesis will be how high iron levels are associated with the increased risk of gestational diabetes development in mothers. I will base my model on Fu, et al, 2016 whose research aimed to summarize the available proof for correlation of body iron status, dietary total iron, and risk of gestational diabetes and Ganz et al. who introduces the idea that hepcidin is a potential factor contributing to gestational diabetes. Finally, I will conclude with the role specific cytokines have on insulin resistance, based on the work of Nieto-Vazquez , et al. and how this may integrate with iron-mediated effects. My interpretations are based on quantitative data, prospective cohort studies and case control studies . I will discuss how consuming large amounts of red meat is correlated with risk of developing gestational diabetes. Fu, et al, mentioned several studies (Sharifi,2010; Chan,2009; Kinnunen,2014; and Gungor,2007) with conflicting arguments on whether or not heme iron affected blood glucose. Iron is an important factor in gestational diabetes development because too much iron can lead to hemochromatosis in the pancreas which could develop to Type-1 diabetes from tissue destruction. Tissue damage from hemochromatosis attracts immune cells (Monocytes) that release Interleukin-6 cytokines, which are known to interfere with blood glucose homeostasis. The liver is an important organ involved in gestational diabetes because of its role in releasing hepcidin , which is a hormone involved in the inhibition of heme-iron’s release into circulation. The goal of my thesis is to contribute to the growing knowledge pertaining to gestational diabetes by focusing on the relationship that iron has in increasing a mother’s risk of developing gestational diabetes. Given the recent literature regarding iron and gestational diabetes, the discovery of iron as a potential risk factor may contribute to development of effective new protocols for pregnant women to prevent gestational diabetes.