Metformin and insulin treatment of gestational diabetes : effects on inflammatory markers and IGF-binding protein-1-secondary analysis of a randomized controlled trial

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Huhtala , M S , Tertti , K , Juhila , J , Sorsa , T & Rönnemaa , T 2020 , ' Metformin and insulin treatment of gestational diabetes : effects on inflammatory markers and IGF-binding protein-1-secondary analysis of a randomized controlled trial ' , BMC Pregnancy and Childbirth , vol. 20 , no. 1 , 401 . https://doi.org/10.1186/s12884-020-03077-6

Title: Metformin and insulin treatment of gestational diabetes : effects on inflammatory markers and IGF-binding protein-1-secondary analysis of a randomized controlled trial
Author: Huhtala, Mikael S.; Tertti, Kristiina; Juhila, Juuso; Sorsa, Timo; Rönnemaa, Tapani
Contributor organization: HUS Head and Neck Center
Department of Oral and Maxillofacial Diseases
University of Helsinki
Helsinki University Hospital Area
Date: 2020-07-11
Language: eng
Number of pages: 10
Belongs to series: BMC Pregnancy and Childbirth
ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-020-03077-6
URI: http://hdl.handle.net/10138/319149
Abstract: Background: Gestational diabetes mellitus (GDM) is characterized by disturbed glucose metabolism and activation of low-grade inflammation. We studied whether metformin treatment has favorable or unfavorable effects on inflammatory markers and insulin-like growth factor-binding protein 1 (IGFBP-1) in GDM patients compared with insulin, and whether these markers associate with major maternal or fetal clinical outcomes. Methods: This is a secondary analysis of a previous randomized controlled trial comparing metformin (n = 110) and insulin (n = 107) treatment of GDM. Fasting serum samples were collected at the time of diagnosis (baseline, mean 30 gestational weeks [gw]) and at 36 gw. Inflammatory markers serum high-sensitivity CRP (hsCRP), interleukin-6 (IL-6), matrix metalloproteinase-8 (MMP-8) and glycoprotein acetylation (GlycA) as well as three IGFBP-1 phosphoisoform concentrations were determined. Results: In the metformin and insulin groups combined, hsCRP decreased (p = 0.01), whereas IL-6 (p = 0.002), GlycA (p <0.0001) and all IGFBP-1 phosphoisoforms (p <0.0001) increased from baseline to 36 gw. GlycA (p = 0.02) and non-phosphorylated IGFBP-1 (p = 0.008) increased more in patients treated with metformin than those treated with insulin. Inflammatory markers did not clearly associate with pregnancy outcomes but non-phosphorylated IGFBP-1 was inversely associated with gestational weight gain. Conclusions: Metformin had beneficial effects on maternal serum IGFBP-1 concentrations compared to insulin, as increased IGFBP-1 related to lower total and late pregnancy maternal weight gain. GlycA increased more during metformin treatment compared to insulin. The significance of this observation needs to be more profoundly examined in further studies. There were no evident clinically relevant relations between inflammatory markers and pregnancy outcome measures.
Subject: Gestational diabetes
Metformin
Low-grade inflammation
Insulin-like growth factor-binding protein 1
IGFBP-1
OBESE PREGNANT-WOMEN
PROTEIN-1
SERUM
RISK
MELLITUS
PRETERM
HYPERGLYCEMIA
ASSOCIATION
OVERWEIGHT
MEDIATORS
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: acceptedVersion


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