The association of plasma levels of liver enzymes and risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis of observational studies

Wei Zhao, Li Zhang, Guoliang Zhang, Hamed Kord Varkaneh, Jamal Rahmani, Cain Clark, Paul M Ryan, Hebatullah M Abdulazeem, Ammar Salehisahlabadi

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    5 Citations (Scopus)
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    Abstract

    Aims: Relationship between liver enzymes such as gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate transaminase (AST) and alkaline phosphatase and risk of gestational diabetes mellitus (GDM) is a controversial issue. The aim of this systematic review and dose–response meta-analysis was to investigate 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) were evaluated by DerSimonian and Laird random-effects models. Dose–response analyses of these relationships were also carried out. Results: Eight studies with 25,451 participants containing 2549 cases were 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, I 2 84%). In addition, random-effects model indicated a dramatic and direct significant association between GGT and risk of GDM in nonlinear (p < 0.001) and linear (p < 0.001) dose–response analysis. Associations between ALT and AST with risk of GDM were found to be non-significant (OR 1.32, 95% CI 0.91–1.90, I 2 65% and OR 0.76, 95% CI 0.52–1.10, I 2 16%, respectively). Conclusion: This systematic review and dose–response meta-analysis highlights GGT as a significant and robust predictor of the incidence of GDM in pregnant women.

    Original languageEnglish
    Pages (from-to)635–644
    Number of pages10
    JournalActa Diabetologica
    Volume57
    Issue number6
    Early online date28 Nov 2019
    DOIs
    Publication statusPublished - 1 Jun 2020

    Bibliographical note

    The final publication is available at Springer via http://dx.doi.org/10.1007/s00592-019-01458-8

    Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

    Keywords

    • Gamma-glutamyl transferase
    • Gestational diabetes mellitus
    • Liver enzymes

    ASJC Scopus subject areas

    • Internal Medicine
    • Endocrinology, Diabetes and Metabolism
    • Endocrinology

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