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Ferritin and iron supplements in gestational diabetes mellitus: less or more?

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Abstract

Iron metabolism has been found to be closely related to gestational diabetes mellitus (GDM). Excessive ferritin levels were shown to be related to an increased risk of GDM because of iron overload which may lead to insulin resistance and β-cell injury by enhancing oxidative stress and inflammatory responses. On the contrary, insufficient ferritin levels can cause a number of obstetric complications, such as high incidence rates of anaemia and gestational hypertension. Therefore, high or low ferritin levels may have adverse effects on the mother and the foetus, putting clinicians in a dilemma when giving pregnant women iron supplements. This also explains why there have been more conflicting findings in the studies on dietary or oral iron supplementation during pregnancy. Hence, there is an urgent need for more evidence and strategies for appropriate recommendations for ferritin levels and iron supplementation during pregnancy to prevent iron insufficiency without causing iron overload and increasing the risk of GDM. Therefore, we gave an updated review on the association of GDM with ferritin metabolism, ferritin levels and iron supplementation based on the summary of the latest research.

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Abbreviations

GDM:

Gestational diabetes mellitus

WHO:

World Health Organization

ROS:

Reactive oxygen species

NF-κB:

Nuclear factor-κB

TNF-α:

Tumour necrosis factor-α

IL:

Interleukin

CRP:

C-reactive protein

TBARS:

Thiobarbituric acid reactive substances

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Acknowledgements

Professional language writing support was provided by Vikas Narang of Editage.cn.

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This article was funded by Diabetes Mellitus Research Fund Program_1_09 from Shanghai Health and Medical Development Foundation.

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  1. Department of Endocrinology, Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, 110022, Liaoning, China

    Tianlian Li, Jingfan Zhang & Ping Li

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  1. Tianlian Li
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TL searched literatures and wrote the manuscript. JZ helped with the writing. PL proposed the idea and revised the manuscript. All authors gave their final approval of the version to be published and agreed to be accountable for all aspects of this work.

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Li, T., Zhang, J. & Li, P. Ferritin and iron supplements in gestational diabetes mellitus: less or more?. Eur J Nutr 63, 67–78 (2024). https://doi.org/10.1007/s00394-023-03250-5

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