The relationship between iron metabolism, stress hormones, and insulin resistance in gestational diabetes mellitus

AIM: To analyze the relationship between iron metabolism index and stress hormones, insulin resistance, and oxidative stress in gestational diabetes mellitus (GDM). METHODS: From January to November 2019, 75 patients with GDM were selected as GDM group, according to age of 1:1; 75 normal pregnant women were selected as Control group. Blood glucose, insulin, stress hormones such as cortisol, norepinephrine (NE), and epinephrine (E), and iron metabolism index such as serum iron, serum ferritin (SF), and transferrin saturation (TS) were measured. Insulin resistance was evaluated by homeostasis model insulin resistance index (HOMA-IR). Multiple linear regression was used to analyze the relationship between iron metabolism index and stress hormones, insulin resistance, and oxidative stress. RESULTS: The levels of NE, E, serum iron, SF, and TS saturation in the GDM group were higher than Control group (t = 3.82, 2.75, 3.14, 6.12, and 3.90, P < 0.05, <0.05, <0.05, <0.01, <0.01); HOMA-IR was higher in the GDM group (t = 4.92, P < 0.01); malondialdehyde (MDA) was higher, while superoxide dismutase (SOD) was lower than Control group (t = 5.25, 4.98, both P < 0.01). Epinephrine, norepinephrine, cortisol, and serum ferritin were positively correlated (r = 0.21, 0.17, and 0.21); epinephrine, cortisol, and transferrin were positively correlated (r = 0.12, 0.31). There was a positive correlation between HOMA-IR and SF and TS (r = 0.34, 0.34). MDA was positively correlated with SF and TS (r = 0.24, 0.29); SOD was negatively related to SF and TS (r = −0.12, −0.17). CONCLUSIONS: Iron metabolism index is related to insulin resistance in GDM women. The change in iron metabolism may be involved in the pathogenesis of gestational diabetes caused by stress- adaptive disorder.