Association Between Gestational Diabetes Mellitus and Maternal Bone Metabolism: A Cross-Sectional Study

Gestational diabetes mellitus (GDM) is a prevalent metabolic condition complicated by pregnancy that relates to poor maternal and infant outcomes. The connection between glucose intolerance and a shift in the bone metabolism in pregnant women is a developing field whose applicability of bone turnover measurements in GDM is yet to be determined. Objectives: To determine the relationship between GDM and maternal bone turnover indices and GDM predictors. Methods: The groups of pregnant women with GDM and those without diabetes were 120 and 60, respectively, in the second trimester of this cross-sectional study. Serum osteocalcin, a cross-linked C-telopeptide of type I collagen (CTX), and bone-specific alkaline phosphatase (B-ALP) were measured. It comprised a series of clinical, biochemical, and obstetric data, such as the body mass index (BMI) and insulin resistance, which was determined using the homeostasis model assessment (HOMA-IR). ROC curve analysis and logistic regression analysis were carried out. Results: GDM women were significantly older women with much higher BMI and HOMA-IR compared to controls (p<0.001). B-ALP level of the GDM group was substantially low (p<0.05), and CTX did not change. The results of the logistic regression analysis identified the independent predictors of GDM as osteocalcin, BMI, and HOMA-IR (OR: 0.565; 0.442-0.722; OR: 1.309; 1.062-1.614; OR: 2.289; 1.090-4.805). The discriminative power (AUC = 0.905; p<0.001) was found to be powerful. Conclusions: GDM is also related to bone metabolism, osteocalcin, BMI, and HOMA-IR are independent predictors.