Maternal gene expression of oxidative stress and inflammatory markers in gestational diabetes mellitus: A case–control study

Abstract

Background: Gestational diabetes mellitus (GDM) is linked to oxidative stress, inflammation, and altered metabolic pathways, but evidence on gene expression related to these mechanisms remains limited. Aims and Objectives: This study compared the expression of oxidative stress markers, nuclear factor erythroid 2-related factor 2 (NRF2) and NAD(P)H quinone dehydrogenase 1 (NQO1), and inflammatory markers RELA and hepcidin antimicrobial peptide (HAMP), in women with and without GDM and examined correlations with pregnancy outcomes. Materials and Methods: A hospital-based case–control study was conducted at a tertiary center (November 2016–April 2018), including 40 women with GDM and 40 normoglycemic controls between 24 and 28 weeks of gestation. GDM was diagnosed using the Diabetes in Pregnancy Study Group India criteria. Peripheral blood gene expression of NRF2, NQO1, RELA, and HAMP was quantified by real-time polymerase chain reaction and analyzed using the 2-ΔΔCt method. The Mann–Whitney U test and multivariable regression analysis (adjusting for maternal age and body mass index [BMI]) were applied. Results: Women with GDM were older (median 27 vs. 25 years; P=0.018) and had a higher BMI (26.8 vs. 24.1 kg/m2; P=0.031). Lower relative expression was observed for NRF2 (P=0.045), NQO1 (P=0.036), and RELA (P=0.004), whereas HAMP did not differ (P=0.19). After adjustment for age and BMI, none remained significant. Maternal and neonatal outcomes were comparable between the groups. Conclusion: GDM was associated with reduced unadjusted expression of NRF2, NQO1, and RELA, but these differences were attenuated after accounting for maternal age and BMI. Larger prospective studies are warranted to clarify the independent role of these molecular markers in GDM pathophysiology.