Homocysteine level and gestational diabetes mellitus: a systematic review and meta-analysis

Abstract

Aims

It is reported that elevated homocysteine (Hcy) level represents an independent risk factor for gestational diabetes mellitus (GDM). However, the relationship between Hcy level and GDM remains controversial. Our study aimed to systematically review available literature linking Hcy to GDM for a comprehensive understanding of the relationship between circulating Hcy level and GDM in humans.

Methods

PubMed, The Cochrane Library, and Web of Science were searched for studies published up to January 2021. Manual searches of references of the relevant studies were also conducted. Standard mean difference (SMD) with 95% confidence interval (95%CI) were calculated to evaluate the relationship between Hcy level and GDM using the Review Manager 5.3 and Stata 12.0.

Results

Of 106 references reviewed, 12 studies with a total of 712 GDM patients contributed to the present meta-analysis. Hcy level was significantly elevated in women with GDM compared with those without GDM (SMD = 0.55; 95% CI: 0.25–0.85, p = .0003). In the subgroup meta-analyses, this evidence was more consistent among women with Hcy sampling during the second trimester (SMD = 0.76, 95% CI: 0.34–1.18, p = .0004) and with average age ≥30 years (SMD = 0.69, 95% CI: 0.25–1.12, p = .002).

Conclusion

The evidence indicated that the level of circulating Hcy was significantly elevated among women with GDM compared with those with normal glucose tolerance, especially with mean age ≥30 years and in the second trimester.

同型半胱氨酸水平与妊娠期糖尿病：一项系统回顾和荟萃分析 摘要

目的：据报道, 同型半胱氨酸水平升高是妊娠期糖尿病的独立危险因素。然而, 同型半胱氨酸水平与妊娠期糖尿病之间的关系仍然存在争议。我们的研究旨在系统地回顾同型半胱氨酸和妊娠期糖尿病相关的现有文献, 以便全面了解人类循环中同型半胱氨酸水平与妊娠期糖尿病之间的关系。

方法：在PubMed、Cochrane图书馆和科学网中搜索截止2021年1月发表的研究。还对相关研究的参考文献进行了人工检索。还对相关研究的参考文献进行了人工检索。使用Review Manager 5.3和Stata 12.0计算标准化均数差及95%置信区间, 以评估同型半胱氨酸水平与妊娠期糖尿病之间的关系。

结果：在回顾的106篇参考文献中, 共有712名妊娠期糖尿病患者参与了12项研究, 为本荟萃分析做出了贡献。与未患妊娠期糖尿病的女性相比, 患有妊娠期糖尿病的女性的同型半胱氨酸水平显著升高（SMD =0.55; 95% CI: 0.25–0.85, p =.0003）。在亚组荟萃分析中, 这一证据在妊娠中期(SMD =0.76, 95% CI: 0.34–1.18, p = .0004)和年龄≥30岁(SMD =0.69, 95% CI: 0.25–1.12, p=.002)进行同型半胱氨酸取样的女性中更为一致。

结论：有证据表明, 与糖耐量正常的女性相比, 妊娠期糖尿病的女性血循环中同型半胱氨酸水平显著升高, 尤其是在平均年龄≥30岁及妊娠中期的女性。

Keywords:

• Gestational diabetes mellitus
• pregnancy
• Hcy
• meta-analysis

Author contributions

Y. Zheng and F.-X. Gong designed the research. Y. Zheng and H.-Y. Deng performed the research. F.-X. Gong and H.-Y. Deng analyzed the data. F.-X. Gong and Z.-Y. Qiao wrote the paper. H.-Y. Deng and Z.-Y. Qiao provided critical feedback and revised the manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors declare that they have no conflict of interest.