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Qamar Sajad
Saira Iqbal
Sara Khan Niazi
Namrah Ahmad
Akashnath Kivalur Ganeshanath
Muhammad Awais
Hosam Alazazzi
Kamel J. K. Walwil
Jumana Abdelrahman Diab


Gestational diabetes mellitus, Bone turnover biomarker, Bone metabolism


Background and Aim: Bone turnover markers (BTMs) can be used to monitor bone formation and bone resorption activity. Maternal age, Vitamin D, obesity, parathyroid hormone (PTH), and prior history of diabetes mellitus are various risk factors for gestational diabetes mellitus (GDM). The objective of the current study aimed to explore the bone turnover markers in gestational diabetes mellitus.

Patients and Methods: This cross-sectional study investigated 102 gestational diabetes mellitus patients in the departments of Endocrine and Gynecology, Fatima Memorial Hospital, Lahore from January 2023 to December 2023. All the pregnant females aged 18-45 years having 24 weeks gestational age with no prior history of diabetes mellitus were included. Patients were classified into two groups; Group-I (Pregnant female with GDM) and Group-II or Control group (Pregnant female without GDM). All the patients underwent detailed history, physical examination, and bone turnover markers in terms of Vitamin D, serum ALP, parathyroid hormone, and serum-ionized calcium were measured and compared with the control group. Data analysis was done using SPSS version 27.

Results: The number of patients in Group-I and Group-II was 60 (58.8%) and 42 (41.2%), respectively. The overall mean age in Group-I and Group-II was 27.8 ± 2.8 years and 26.32 ± 2.86, respectively. The mean BMI, Ionized calcium, Vitamin D, and Serum PTH in both groups were as follows; (25.86 ± 3.51 kg/m2 vs. 23.98 ± 2.62 kg/m2, 4.58 ± 0.379 m-Eq/L vs. 4.59 ± 0.349 m-Eq/L, 31.256 ± 8.41 ng/ml vs. 20.98 ± 9.52 ng/ml, and 36.28 ± 8.13 pg/ml vs. 70.391 ± 35.192 pg/ml, respectively). Serum ALP in Group-I and Group-II was 8.9 ± 4.61 KA U/dl and 6.99 ± 2.1 KA U/dl, respectively.

Conclusion: The present study observed that pregnant female with gestational diabetes mellitus (GDM) are more susceptible to obesity, lower parathyroid hormone, and lower vitamin D levels as compared to control group. This provide a justification for the assessment of bone turnover markers at early stages for better positive and health outcome.

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