Is there any association between kisspeptin levels and gestational
diabetes mellitus?
Cihan Toğrul ,Ümit Görkem, Emine Arslan, Nafiye Yılmaz Hitit University Medical School, Department of Obstetrics and
Gynecology, Çorum, Turkey
Purpose:
• The aim of the study is to investigate the associations of kisspeptin levels with gestational diabetes mellitus (GDM).
• Kisspeptin is a peptide originally identified from a metastasis- supressor gene (KISS 1) in malignant melanomas
• In addition to its importance in metastasis supressor, particularly high expression in placenta
• In vitro, kisspeptin inhibits the migration and invasion of trophoblast
cells, and thus, it is postulated that kisspeptin potentially plays a key
role in restraining trophoblast invasion and regulating implantation
and subsequent placental development
Methods:
• This cross-sectional study was underwent in the Obstetrics and Gynecology Department of Hitit University between March, 2015 and September, 2015.
• A total of 158 pregnant women were screened between 24 and 28 weeks of gestation.
• All of the low risk pregnant women were evaluated with a 50-g glucose challenge test (GCT).
• Women with serum glucose ≥ 140 mg/dL at 1 h after GCT were subjected to a 100-g oral glucose tolerance test (OGTT)
• 76 of the GDM group, 82 of the control group.
• Maternal serum concentrations of kisspeptin, insulin and homeostasis model assessment-insulin resistance (HOMA-IR) were assessed.
Results
• No difference in maternal age and gestational duration between the GDM group and the controls (p=0.058 and p=0.820 respectively) was confirmed
• The median of body mass indexes (BMI) of both groups were statistically similar (p=0.062).
• The significant increases in serum insulin and HOMA concentrations were confirmed in GDM group (p<0.001 and p<0.001, respectively).
• There was no statistically significant difference of serum kisspeptin
level between healthy pregnants and pregnants with GDM (p=0.280).
Control Group (n=82)
GDM Group
(n=76)
p
Maternal age (years) 27.9 ±5.2 30.5 ±5.8 0.058
BMI (kg/m2) 28.6 ± 4.3 30.6 ± 3.7 0.062
Gestational duration (weeks) 25.0± 5.0 23.0 ± 7.9 0.820
Insulin (mIU/mL) 10.5 ± 4.9 16.2 ± 6.5 <0.001*
HOMA-IR 1.8 ± 0.9 4.1 ± 1.9 <0.001*
Kisspeptin (ng/mL) 161.3 ± 78.2 187.6 ± 132.3 0.280
Table 1. Comparisons of clinical and biochemical parameters in control and gestational diabetes groups
Abbreviations:Values are shown as mean ± standart deviation. GDM; gestational diabetes, BMI; Body mass index, HOMA-IR; Homeostasis model assessment of insulin resistance.
* p-values indicate statistically significant (p< 0.05).
Control Group GDM Group
Maternal age (years)
-0.277 0.004
BMI (kg/m2)
-0.172 -0.118
Gestational duration (weeks)
-0.003 -0.086
Insulin (mIU/mL)
-0.222 -0.254
HOMA-IR
-0.216 -0.127
Table 2. Correlations of kisspeptin with other study parameters in control and gestational diabetes groups
Abbreviations: Values are shown as Pearson's correlation coefficient (r). GDM; gestational diabetes, BMI; Body mass index, HOMA-IR; Homeostasis model assessment of insulin resistance.. All p values are found as > 0.05.
Conclusion
• In our study, Kisspeptin levels are higher in GDM group, but difference is not statistically significant ( p > 0.05).
• We could not demonstrate a significant correlation with other parameters ( Age, BMI, Insulın levels, Gestational week..)
• Previous data revealed decreased levels of kisspeptin in GDM (Cetkovic et al. 2012)
• Also there are few studies that examined kisspeptin levels in women PE, some reporting significantly lower and some reporting significantly higher levels. ( due to different assay methods? )
• Mice models of obesity and type 2 diabetes mellitus revealed increased hepatic kisspeptin expression and kisspeptin plasma levels(Judit Hajagos- Tóth et al. 2017)
