Evaluation of Malondialdehyde (MDA) Levels and Some Inflammatory Cytokines as Early Biomarkers for the Detection of Gestational Diabetes in Kirkuk City

Main Article Content

Marwa Jassim Mohammed
Wedad Mahmood L Al-obaidi

Abstract

Gestational diabetes is a glucose intolerance disorder that occurs during pregnancy because hormonal and immunological changes increase insulin resistance, including elevated inflammatory cytokines such as Tumor Necrosis Factor-alpha (TNF-α) and Interleukin-6 (IL-6), which impair cells' response to insulin. This study aimed to evaluate physiological and immune variables associated with gestational diabetes, including malondialdehyde (MDA), Glutathione (GSH), IL-6, and TNF-α. (60) blood samples were collected from pregnant women in the (10-12) weeks of pregnancy with a body mass index (BMI) ≥30 (A). After follow-up in the second trimester (20-24 weeks), they were divided into two groups (B and C) based on blood glucose levels. The results showed a significant increase(P<0.001) in both fasting blood sugar (FBS) and Hemoglobin A1c (HbA1c), As for oxidative stress markers such as glutathione (GSH) there were no significant differences (P>0.05), but MDA record high significant differences(P<0.001), likewise for inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in obese pregnant women with Gestational diabetes mellitus (GDM) compared to those without GDM in the first trimester. In conclusion, elevated levels of FBS, HbA1c, and insulin resistance, along with increased oxidative stress and inflammation markers, were evident in pregnant women diagnosed with GDM relative to non-GDM pregnant women.

Article Details

How to Cite
Jassim Mohammed, M., & Mahmood L Al-obaidi, W. (2026). Evaluation of Malondialdehyde (MDA) Levels and Some Inflammatory Cytokines as Early Biomarkers for the Detection of Gestational Diabetes in Kirkuk City. Tikrit Journal of Pure Science, 31(4), 41–50. https://doi.org/10.25130/tjps.v31i4.2061
Section
Articles

References

[1] Sulaiman, A. H., Ghassan, Z. I., & Omar, T. N. (2022). Biochemical Evaluation of Carbonic Anhydrase and Some Antioxidant Markers in Patients with Diabetes Complications. Archives of Razi Institute, 77(1), 169.‏ https://doi.org/10.22092/ARI.2021.356308.1817

[2] Azeez, D. D., AlKatib, S. R., & Aziz, N. D. (2024). Exploring Interleukin 6 as a Promising Marker for The Diagnosis of Gestational Diabetes Mellitus. Karbala Journal of Pharmaceutical Sciences, 14(23), 106-115.‏ ‏ https://doi.org/10.62472/kjps.v14.i23.106-115

[3] Jader, R., & Aminifar, S. (2023). An Intelligent Gestational Diabetes Mellitus Recognition System Using Machine Learning Algorithms. Tikrit Journal of Pure Science, 28(1), 82-88.‏ https://doi.org/10.25130/tjps.v28i1.1269

[4] Shareef LA, Abdulrahman CG, Salih SM. Relation of Vitamin D With Macrosomia in Pregnant Women Attending Kirkuk General Hospital. Med J Tikrit Univ. 2019;25(2). Available from: https://mjtu.tu.edu.iq/index.php/mjtu/article/view/41

[5] Choudhury, A. A., & Rajeswari, V. D. (2021). Gestational diabetes mellitus-A metabolic and reproductive disorder. Biomedicin & Pharmacotherapy, 143, 112183. https://doi.org/10.1016/j.biopha.2021.112183

[6] Byford, A. R. (2023). The impact of maternal glucose fluctuations in gestational diabetes on placental development (Doctoral dissertation, University of Leeds).‏

[7] Szlapinski, S. K., & Hill, D. J. (2024). In vivo models of gestational and type 2 diabetes mellitus characterized by endocrine pancreas cell impairments. Journal of Endocrinology, 260(3).‏ https://doi.org/10.1530/JOE-23-0317

[8] Lee, S. H., Park, S. Y., & Choi, C. S. (2022). Insulin resistance: from mechanisms to therapeutic strategies. Diabetes & metabolism journal, 46(1), 15-37.‏

[9] Sies H, Berndt C, Jones DP. Oxidative stress. Annual review of biochemistry. 2017 Jun 20;86(1):715-48.‏ https://doi.org/10.1146/annurev-biochem-061516-045037

[10] Bhatti, J. S., Sehrawat, A., Mishra, J., Sidhu, I. S., Navik, U., Khullar, N., ... & Reddy, P. H. (2022). Oxidative stress in the pathophysiology of type 2 diabetes and related complications: Current therapeutics strategies and future perspectives. Free Radical Biology and Medicine, 184, 114-134.‏ https://doi.org/10.1016/j.freeradbiomed.2022.03.019

[11] Grzeszczak, K., Łanocha-Arendarczyk, N., Malinowski, W., Ziętek, P., & Kosik-Bogacka, D. (2023). Oxidative stress in pregnancy. Biomolecules, 13(12), 1768.‏ https://www.mdpi.com/2218-273X/13/12/1768#

[12] Ersahin, S. S., & Yurci, A. (2021). Cord blood and maternal serum preptin and irisin concentrations are regulated independently in GDM. European Review for Medical & Pharmacological Sciences, 25(4).‏

[13] Basu, J., Datta, C., Chowdhury, S., Mandal, D., Mondal, N. K., & Ghosh, A. (2020). Gestational diabetes mellitus in a tertiary care hospital of Kolkata, India: prevalence, pathogenesis and potential disease biomarkers. Experimental and clinical endocrinology & diabetes, 128(04), 216-223.‏ https://doi.org/10.1055/a-0794-6057

[14] Djelti, F., Merzouk, H., Merzouk, S. A., & Narce, M. (2015). In vitro effects of oil's fatty acids on T cell function in gestational diabetic pregnant women and their newborns. Journal of Diabetes, 7(4), 512-522.‏ https://doi.org/10.1111/1753-0407.12210

[15] Wang, J., Zhu, Q. W., Cheng, X. Y., Sha, C. X., & Cui, Y. B. (2020). Clinical significance of neutrophil–lymphocyte ratio and monocyte–lymphocyte ratio in women with hyperglycemia. Postgraduate medicine, 132(8), 702-708. https://doi.org/10.1080/00325481.2020.1764235

[16] Omazić, J., Viljetić, B., Ivić, V., Kadivnik, M., Zibar, L., Müller, A., & Wagner, J. (2021). Early markers of gestational diabetes mellitus: what we know and which way forward?. Biochemia medica, 31(3), 0-0.‏ https://doi.org/10.11613/BM.2021.030502

[17] Rezaieg, N. S. (2024). From Calories to Nutrients: The Role of Lifestyle Changes for Addressing Obesity. Tikrit Journal of Pure Science, 29, 6.‏ https://doi.org/10.25130/tjps.v29i6.1675

[18] Martínez-Martínez, E., & Cachofeiro, V. (2022). Oxidative stress in obesity. Antioxidants, 11(4), 639. https://doi.org/10.3390/antiox11040639

[19] Ibrahim, N. A. K.(2025). Assessment of the Insulin Resistance, Inflammatory Markers and Gene Polymorphism in Polycystic Ovarian Syndrome Patients.‏ Kirkuk Journal of Science Vol. 20, Iss. 1, p. 1-10. https://doi.org/10.32894/kujss.2025.155788.1187

[20] Ma, N., Bai, L., & Lu, Q. (2024). First-Trimester triglyceride-glucose index and Triglyceride/High-Density Lipoprotein Cholesterol are predictors of Gestational Diabetes Mellitus among the four surrogate biomarkers of insulin resistance. Diabetes, Metabolic Syndrome and Obesity, 1575-1583.‏

[21] Xu, X., Luo, S., Lin, J., Zhou, J., Zheng, L., Yang, L., ... & Wu, S. (2024). Association between maternal lipid profiles and lipid ratios in early to middle pregnancy as well as their dynamic changes and gestational diabetes mellitus. BMC Pregnancy and Childbirth, 24(1), 510.‏ https://doi.org/10.1186/s12884-024-06692-9

[22] Abdaljalil, A. M., & Khaleel, F. M. (2025). Assessing the Role of GSK3 β and Arrestin Beta1 in Regulating Oxidative Stress that Causes Metabolic Disorders. Science, 20(1), 43-53.‏ https://doi.org/10.32894/kujss.2025.157067.1193

[23] Torres-Torres, J., Monroy-Muñoz, I. E., Perez-Duran, J., Solis-Paredes, J. M., Camacho-Martinez, Z. A., Baca, D., ... & Reyes-Muñoz, E. (2024). Cellular and molecular pathophysiology of gestational diabetes. International Journal of Molecular Sciences, 25(21), 11641.‏ https://doi.org/10.3390/ijms252111641

[24] Gu, Z. J., Song, Q. J., Gu, W. Q., Zhang, G. P., Su, Y., Tang, Y., ... & Chen, J. (2023). New approaches in the diagnosis and prognosis of gestational diabetes mellitus. European Review for Medical & Pharmacological Sciences, 27(21).

[25] Muhuza, M. P. U., Zhang, L., Wu, Q., Qi, L., Chen, D., & Liang, Z. (2023). The association between maternal HbA1c and adverse outcomes in gestational diabetes. Frontiers in Endocrinology, 14, 1105899.‏ https://doi.org/10.3389/fendo.2023.1105899

[26] Zhang, Y., Ye, Y., Jia, X., Wang, P., Xiong, Z., & Zhu, H. (2025). The protective effects of Salusin-α against oxidative stress and inflammatory response in mice with gestational diabetes mellitus (GDM). Archives of Physiology and Biochemistry, 1-10. https://doi.org/10.1080/13813455.2025.2456876

[27] Zeng, Y., Yin, L., Yin, X., & Zhao, D. (2023). Association of triglyceride-glucose index levels with gestational diabetes mellitus in the US pregnant women: a cross-sectional study. Frontiers in endocrinology, 14, 1241372.‏ https://doi.org/10.3389/fendo.2023.1241372

[28] Li, Y., Wang, X., Jiang, F., Chen, W., Li, J., & Chen, X. (2021). Serum lipid levels in relation to clinical outcomes in pregnant women with gestational diabetes mellitus: an observational cohort study. Lipids in Health and Disease, 20, 1-8.‏ https://doi.org/10.3389/fendo.2023.1241372

[29] Rahnemaei, F. A., Pakzad, R., Amirian, A., Pakzad, I., & Abdi, F. (2021). Effect of gestational diabetes mellitus on lipid profile: A systematic review and meta-analysis. Open Medicine, 17(1), 70-86.‏ https://doi.org/10.1515/med-2021-0408

[30] Manell, H., Kristinsson, H., Kullberg, J., Ubhayasekera, S. J. K., Mörwald, K., Staaf, J., ... & Bergsten, P. (2019). Hyperglucagonemia in youth is associated with high plasma free fatty acids, visceral adiposity, and impaired glucose tolerance. Pediatric Diabetes, 20(7), 880-891.‏ https://doi.org/10.1111/pedi.12890

[31] Di Bartolo, B. A., Cartland, S. P., Genner, S., Manuneedhi Cholan, P., Vellozzi, M., Rye, K. A., & Kavurma, M. M. (2021). HDL improves cholesterol and glucose homeostasis and reduces atherosclerosis in diabetes‐associated atherosclerosis. Journal of Diabetes Research, 2021(1), 6668506.‏ https://doi.org/10.1155/2021/6668506

[32] Abbood, J. J., & Al-Obaidi, W. M. L. (2024). Evaluation of Fat Levels in Obese Women with Diabetes in Kirkuk City. Central Asian Journal of Medical and Natural Science, 5(4), 735-741.

[33] Fang, L., Lu, S., Fang, L., Yu, J., Kakongma, N., & Hu, W. (2025). Metformin ameliorates Gestational Diabetes Mellitus via inhibiting ferroptosis of trophoblasts through the Nrf2/HO-1 signaling pathway. Free Radical Research, (just-accepted), 1-17.‏ https://doi.org/10.1080/10715762.2025.2468737

[34] Jakubiak, G. K., Osadnik, K., Lejawa, M., Osadnik, T., Goławski, M., Lewandowski, P., & Pawlas, N. (2021). “Obesity and insulin resistance” is the component of the metabolic syndrome most strongly associated with oxidative stress. Antioxidants, 11(1), 79.‏ https://www.mdpi.com/2076-3921/11/1/79#

[35] Kanikowska, D., Kanikowska, A., Swora-Cwynar, E., Grzymisławski, M., Sato, M., Bręborowicz, A., ... & Korybalska, K. (2021). Moderate caloric restriction partially improved oxidative stress markers in obese humans. Antioxidants, 10(7), 1018.‏ https://doi.org/10.3390/antiox10071018

[36] Ali, A. S., Hachim, S. K., & Saleh, Z. M. (2022). The role of il-6 in inflammatory reaction during Coronavirus-19 infection: a review.‏‏ https://doi.org/10.24321/0019.5138.202233