A Meta-analysis Of Serum Uric Acid Levels In Pregnant With Gestational Diabetes And Non-gestational Diabetes

Background and objective:Gestational diabetes mellitus(GDM)is one of the most common complications of pregnancy and has a long-term and serious impact on both the mother and the infant.GDM is a pathological state of glucose intolerance during pregnancy which is a form of pre-diabetic stage occurring in pregnancy.The diagnosis of GDM was mainly dependent on oral glucose tolerance test(OGTT)at 24-28 weeks of pregnancy,and there was no preliminary screening method.There are Studies shown that serum uric acid levels are associated with insulin resistance.However,the correlation between serum uric acid level and gestational diabetes mellitus(GDM),and whether serum uric acid level can be used as a biological indicator for the preliminary screening of gestational diabetes remains controversial.We conducted a meta-analysis to investigate whether uric acid during pregnancy was associated with the risk of gestational diabetes mellitus.Methods:A systematic search of the published literature about uric acid and women with GDM will be included.Databases including Pub Med,Elsevier,The Cochrane Library and Web of Science were searched studiespublished up to February 2018.We searched the key words : gestational diabetes mellitus,pregnancy,diabetes,glucose tolerance,hyperinsulinemia,uric acid,hyperuricemia,etc.In addition,Manual searches of references of the relevant original studies were carried out.The overall effect was reported in a standard mean difference(SMD).All data were analyzed with Revman manager 5.3 software.Results:This study included nine articles finally,The population of these articles comes from Greece,Turkey,Egypt,Italy,China,India,Iran,Israel.There were 7,301 population enrolled in the study,including 776 women with gestational diabetes mellitus and 6,525 women with non-gestational diabetes mellitus.Serum uric acid levels in gestational diabetes mellitus group were significantly elevated than those in the non-gestational diabetes group(SMD = 0.23;95% CI: 0.10,0.36).Subgroup analysis showed that serum uric acid level in gestational diabetes mellitus group were elevated than that of non-gestational diabetes group during the first 20 weeks of pregnancy(SMD = 0.23;95%CI:0.14,0.31),and it was not supported in the later 20 weeks of pregnancy.Conclusion:The available evidence suggested that serum uric acid level is higher in women with GDM compared with women with non-GDM.and this finding consistent during the first 20 weeks of pregnancy.However,whether serum uric acid can be used as a biological indicator for preliminary screening of gestational diabetes still needs further study.