Elevated Maternal Serum Folate Concentrations are Associated with Risk of Developing Gestational Diabetes Mellitus

Author(s): Tasnim R, Nurullah M, Rahman AKMS, Akhter M, Jahan LI, Patwary T, Bhuiyan MMA, Ferdoushi S, Islam MS, Rahman MQ

Background: Gestational diabetes mellitus (GDM) is a metabolic disorder and one of the common complications in all pregnancies. Folate serves in synthesis of methionine from homocysteine. High folate level inhibits DNA synthesis and elevates homocysteine. An elevated serum homocysteine level linked with insulin resistance which is associated with GDM.

Objective: This study was aimed to examine the association of serum folate concentrations with its risk of developing GDM.

Methods: This study was conducted at the Department of Laboratory Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2021 to February 2022. A total of 43 pregnant women with GDM were selected as cases and 43 healthy pregnant women were taken as control group. The demographic profile and a full clinical history of the study population were recorded accordingly. Maternal serum folate concentrations were estimated following standard procedure. Data were analyzed and compared by statistical tests.

Results: The mean(±SD) age of the GDM women was 31.35±3.02 years and that was 25.19±2.65 years in control group. It was found that mean(±SD) serum folate concentrations was significantly high in GDM women (23.36±10.20 nmol/L versus 10.86±8.34 nmol/L, p= 0.001). In multivariate logistic regression analysis the odd ratio of serum folate with GDM was 4.977 (95% CI; p= 0.031). There was a positive correlation observed between serum folate concentrations of GDM women and their plasma glucose levels [fasting plasma glucose (r=+0.597, p<0.001); plasma glucose 1 hour after 75 gm glucose (r=+0.492, p= 0.001) and plasma glucose 2 hours after 75 gm glucose (r=+0.449, p=0.003)].

Conclusion: Maternal serum folate concentration is significantly higher in patients with GDM women than healthy pregnant women. High maternal serum folate concentrations are associated with risk of developing GDM. Serum folate may be used as a predictive tool to identify risk of developing GDM.