title: The Value of Total antioxidant Status and Serum Tumor Necrosis Factor-α Levels at 24-28 Weeks of Gestation in the Prediction of Optimal Treatment Protocol in Gestational Diabetes Mellitus.
abstract: OBJECTIVE
  The aim of this study was to investigate the serum oxidative stress markers, antioxidant enzyme and tumor necrosis factor-α (TNF-α) levels at 24-28 weeks of gestation and to evaluate the predictive value of them on the subsequent treatment protocol in gestational diabetes mellitus (GDM).
  
  
  METHODS
  A total of 58 GDM patients (30 treated with only conventional healthy dietary recommendation (CHDR), 28 treated with insulin) and 30 healthy pregnant women at 24-28 weeks of gestation, were enrolled in this prospective case-control study. The oxidative status, antioxidant enzyme and TNF-α levels were evaluated to determine if there is an association with the need of insulin therapy for glycemic control by using multivariable logistic regression analysis.
  
  
  RESULTS
  TNF-α (OR=11.976, 95%CI: 2.441-58.754,P=0.002) and total antioxidant status (TAS) (OR=12.769, 95%CI: 2.464-66.182,P=0.002) were found to be predictive for GDM at 24-28 weeks of gestation. Besides, further evaluation considering the treatment modality showed that increased TNF-α (OR=18.615, 95%CI: 2.338-148.240,P=0.006) and lower TAS levels (OR=99.471, 95%CI: 2.865-3 453.061,P=0.011) were independent predictors of the need for insulin treatment in GDM patients.
  
  
  CONCLUSIONS
  Increased TNF-α levels and low TAS are significantly associated with the increased risk of insulin requirement for achieving good glycemic control in GDM.
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Ozler
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Oztas
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Uygur
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: A O
authors.initials: AO
authors.lastname: Ersoy
authors.affiliation: Department of Clinical Biochemistry, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ergin
authors.affiliation: Department of Clinical Biochemistry, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Koca
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Danisman
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Erkaya
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage*; D011247:Pregnancy; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D007328:Insulin; D014409:Tumor Necrosis Factor-alpha