The role of iron overload in the development of gestational diabetes mellitus and other metabolic disorders during pregnancy
Saprina T.V., Musina N.N., Pushkareva E.S.
The role of iron in the development of disorders of carbohydrate metabolism has been known for a long time. The first observations were based on the increased risk of diabetes mellitus in patients suffering from hereditary disorders of iron metabolism with increased iron deposition in the liver and pancreas in haemochromatosis. Subsequently, disorders of carbohydrate metabolism during pregnancy (gestational diabetes mellitus) were associated mainly with increased insulin resistance, impaired insulin secretion in genetically predisposed individuals, with obesity and metabolic syndrome in women before gestation. However, there is increasing evidence to support the hypothesis of the role of iron overload associated with metabolic syndrome, metabolically associated fatty liver disease, induction and progression of disorders of carbohydrate metabolism. The article presents current data on the association between disorders of iron metabolism and the risk of developing gestational diabetes mellitus. It discusses the mechanisms how ferrokinetics influence glucose intolerance and considers the role of iron supplements in the development of gestational diabetes mellitus. The review refers to the current clinical recommendations and algorithms of medical care adopted in the Russian Federation and abroad, as well as to the data of some of the most recent studies on the issue.
Conclusion: The process of iron metabolism in pregnant women is complex and involves various regulatory mechanisms. It is associated with metabolic risks that are present before pregnancy or that arise during pregnancy. Iron overload may increase the risk of developing gestational diabetes mellitus, and this should be considered when developing a personalized algorithm for monitoring pregnant women.
Authors' contributions: Saprina T.V., Musina N.N. – developing the concept and design of the study, editing the article; Saprina T.V., Musina N.N., Pushkareva E.S. – collecting and processing the material, writing the text. All authors approved the final version of the article before publication, agreed to be responsible for all aspects of the work, implying proper review and resolution of issues related to the accuracy or integrity of any part of the work.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Saprina T.V., Musina N.N., Pushkareva E.S. The role of iron overload in the development of
gestational diabetes mellitus and other metabolic disorders during pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (5): 5-12 (in Russian)
https://dx.doi.org/10.18565/aig.2024.331
Keywords
gestational diabetes mellitus
dysmetabolic iron overload syndrome
hepcidin
ferritin
transferrin
insulin resistance
hyperglycemia
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Received 23.12.2024
Accepted 17.03.2025
About the Authors
Tatiana V. Saprina, Dr. Med. Sci., Professor, Siberian State Medical University, Ministry of Health of Russia, 2 Moscowsky Trakt, 634050 Tomsk, Russia,tanja.v.saprina@mail.ru, https://orcid.org/0000-0001-9011-8720
Nadezhda N. Musina, PhD, Siberian State Medical University, Ministry of Health of Russia, 2 Moscowsky Trakt, 634050 Tomsk, Russia, nadiezhda-musina@mail.ru,
https://orcid.org/0000-0001-7148-6739
Elizaveta S. Pushkareva, student, Siberian State Medical University, Ministry of Health of Russia, 2 Moscowsky Trakt, 634050 Tomsk, Russia, pushkareva.li@mail.ru,
https://orcid.org/0009-0003-8363-8105
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