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Aims: A retrospective, observational, case control, pilot study investigating the relationship between insulin resistance (IR), renal function and maternal serum chromium (Cr) level in pregnancy. Methods: 115 pregnant women in their first 12 weeks to 40 weeks were initially recruited for the study, involving an oral glucose tolerance test (oGTT) from the Day Assessment unit at Derriford Hospital using the 75 g standard glucose load recommended by WHO. 101 patients were at least 28 weeks gestation, 10 were diagnosed with gestational diabetes mellitus (GDM), 8 of these were included in the study. 34 of these patients at over 28 weeks gestation were further tested for urine and serum Cr and creatinine (GDM, n=8; non-GDM, n=26) and insulin (n=70), IR was calculated. The diagnosed GDM group (n=8) was compared to the normoglycaemic group (n=26) and control group of non-pregnant, normoglycaemic controls (n=8). No statistical significance observed between the groups with respect to age or BMI. Results: Correlation was found between IR and serum Cr/BMI in the whole patient group (p=0.009; R=0.435, n=34) and within the non-GDM patients (R=0.416; p=0.01, n=26 two tailed) but not within the GDM patients (n=8) alone. There was significant correlation in the GDM group only for increased urine creatinine associated with urine Cr levels (p=0.049, R=0.709, n=8) at the 0.05 two-tailed level. Conclusion: Increased IR during pregnancy was related to an increase in serum Cr /BMI levels in non-GDM pregnant women. Deficiency of Cr status may be a pathogenic factor in the development of GDM. We propose a mechanism.

international journal of endocrinology and metabolic disorders

Proposed Relationships between the Degree of Insulin Resistance, Serum Chromium Level/BMI and Renal Function during Pregnancy and the Pathogenesis of Gestational Diabetes Mellitus