Apelin levels in pregnant women with and without gestational diabetes mellitus: a collaborative systematic review and meta-analysis

• Published in: Gynecological endocrinology 2022-10, Vol.38 (10), p.803-812
• Main Authors: Pérez-López, Faustino R., Wu, Jiang-Nan, Yao, Li, López-Baena, María T., Pérez-Roncero, Gonzalo R., Varikasuvu, Seshadri Reddy
• Format: Article
• Language: English
• Subjects: Apelin; body mass index; gestational diabetes mellitus; glucose; HOMA-IR; insulin; lipids; meta-analysis; 体重指数; 妊娠期糖尿病; 胰岛素; 荟萃分析
• ISSN: 0951-3590; 1473-0766
• DOI: 10.1080/09513590.2022.2114450

Aims: This systematic review and meta-analysis investigated maternal apelin levels in pregnant women with and without GDM. Secondary outcomes were glucose- and lipid-related results.Methods: Databases including PubMed, Embase, Cochrane Library, LILACS, CNKI, and Wang Fang were searched. The methodological quality of included studies was evaluated with the Newcastle-Ottawa Scale. Mean differences (MDs) or standardized MDs (SMDs) with their 95% confidence intervals (CIs) were evaluated. Random effect model analyses were carried out and heterogeneity with the I 2 and Tau 2 statistics.Results: Fourteen observational studies (sample size: 1033 women with GDM and 1053 for control women) with a low or moderate risk of bias were included in the analysis. During the second half of pregnancy, maternal apelin estimate was significantly higher in women with GDM (SMD = 0.64; 95% CI: 0.03 to 1.25), as well as insulin (SMD = 1.41% CI: 0.84 to 1.99), glucose (SMD = 1.56; 95% CI 1.20 to 1.91), glycated hemoglobin (SMD = 1.11, 95% CI: 0.69 to 1.54), HOMA-IR (MD = 2.25; 95%CI: 1.51 to 2.98), BMI (MD = 0.80 kg/m 2 , 95%CI: 0.52 to 1.08), total cholesterol (SMD = 0.42, 0.12 to 0.73), LDL-cholesterol (SMD = 0.63, 95%CI: 0.23 to 1.02), and triglycerides (SMD = 0.40, 95%CI: 0.19 to 0.61) as compared to control women. There was heterogeneity between studies as evidence by high I 2 values. Meta-regression analysis indicated statistically significant regression coefficients for age of women, glucose and total cholesterol.Conclusions: GDM was associated with increased circulating apelin, insulin, glucose, glycated hemoglobin, total cholesterol, LDL-cholesterol levels, and HOMA-IR index.