Association of Elevated Serum Ferritin Levels and the Risk of Gestational Diabetes Mellitus in Pregnant Women
The Camden Study
- Xinhua Chen, MD1,
- Theresa O. Scholl, PHD1 and
- T. Peter Stein, PHD2
- 1Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey–SOM, Stratford, New Jersey
- 2Department of Surgery, University of Medicine and Dentistry of New Jersey–SOM, Stratford, New Jersey
- Address correspondence and reprint requests to Dr. Theresa O. Scholl, Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey–SOM, 2 Medical Center Dr., Science Center, Suite 390, Stratford, NJ 08084. E-mail: scholl{at}umdnj.edu
Abstract
OBJECTIVE— We examined the influence of a moderately elevated serum ferritin level at entry to care on the risk of gestational diabetes mellitus (GDM) and a possible mechanism (increased iron stores versus inflammation).
RESEARCH DESIGN AND METHODS— In a prospective observational study with 1,456 healthy pregnant women in Camden, New Jersey, serum ferritin and anthropometric measurements were determined. Serum C-reactive protein (CRP) concentration was measured in a nested case-control study of 172 subjects.
RESULTS— Women who developed GDM had a higher concentration of serum ferritin than women who did not develop GDM (P < 0.001). Elevated serum ferritin level (highest quintile) was significantly and positively correlated with prepregnant BMI and skinfold measurements. Women in the highest quintile of serum ferritin had a twofold increased risk of developing GDM adjusted for several known risk factors (adjusted odds ratio, 2.02 [95% CI 1.04–3.92], P < 0.05). Similar results were obtained with a nested case-control study, in which women in the highest tertile of serum ferritin (2.35 [1.06–5.22], P < 0.05) or CRP (2.67 [1.16–6.17], P < 0.001) had a greater than twofold increased risk of GDM. However, these effects were modified and became nonstatistically significant after additional adjustment for prepregnant BMI.
CONCLUSIONS— Elevated serum ferritin concentrations early in gestation are associated with an increased risk of GDM. The association, at least in part, is mediated by the maternal fat mass and obesity. These data suggest a possible link between elevated serum ferritin and low-grade inflammation.
- AOR, adjusted odds ratio
- CVD, cardiovascular disease
- GDM, gestational diabetes mellitus
- CRP, C-reactive protein
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted January 26, 2006.
- Received January 23, 2006.
- DIABETES CARE
