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

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)
5 Downloads (Pure)

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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