Association of Elevated Serum Ferritin Levels and the Risk of Gestational Diabetes Mellitus in Pregnant Women
Open accessAbstract
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.
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Iron excess is a known feature of gestational diabetes and a clear risk factor for diabetes even in normal populations; diabetes is a classical consequence of iron overloading in hereditary haemochromatosis.
“Iron 'excess' is also a known feature of gestational diabetes [591-593], and is a clear risk factor for the disease even in 'normal' populations [594-603], and indeed diabetes is a classical consequence of iron overloading as seen in hereditary haemochromatosis [604].”
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- Authors
- Chen, X., Scholl, T. O., & Stein, T. P.
- Affiliations
- University of Medicine and Dentistry of New Jersey (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2006-05-01
- Volume
- 29
- Issue
- 5
- Pages
- 1077-1082
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W3128056293
- Cited by
- 122
- References
- 29
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 4 · 2023: 9 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 7 · 2018: 8 · 2017: 8 · 2016: 11 · 2015: 1 · 2014: 8 · 2013: 7 · 2012: 12
- FWCI
- 5.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- Funders
- National Institute of Child Health and Human Development
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- gestational diabetes mellitus, serum ferritin, iron stores, C-reactive protein, low-grade inflammation, obesity, pregnancy, risk factors
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