Background: Relation between liver enzymes such as gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) and risk of gestational diabetes mellitus (GDM) is a controversial issue. The aim of this systematic review and dose-response meta-analysis was investigation the association between liver enzymes and risk of GDM in observational studies.Methods: A Comprehensive systematic literature search was conducted in MEDLINE/PubMed, SCOPUS, and Web of Science databases up to September 2019. Combined odds ratios (ORs) with 95% confidence intervals (CIs) evaluated by DerSimonian and Laird random-effects models. Dose-response analysis was also carried out.Results: Eight studies with 25,451 participants containing 2,549 case included in this study. Pooled results showed a significant association between GGT levels and risk of GDM (OR: 2.10, 95% CI: 1.14-3.86, I2: %84). Random-effects model indicated a dramatic direct significant association between GGT and risk of GDM in non-linear (p<0.001) and linear (p<0.001) dose-response analysis too. Association between ALT and AST with risk of GDM were non-significant (OR: 1.32, 95% CI: 0.91-1.90, I2: %65) and (OR: 0.76, 95% CI: 0.52-1.10, I2: %16), respectively.Conclusion: Finally, this systematic-review and dose-response meta-analysis highlights GGT may be a significant predictor related to the incidence of gestational diabetes mellitus.Keywords: gestational diabetes mellitus; gamma-glutamyl transferase; Liver enzymes.
|Publication status||Accepted/In press - 7 Nov 2019|
Zhao, W., Zhang, L., Zhang, G., Kord-Varkaneh, H., Clark, C., Rahmani, J., ... Salehisahlabadi, A. (Accepted/In press). Plasma levels of liver enzymes and risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis of observational studies. Acta Diabetologica, (In-press), (In-press).