Serum Zinc ɑ-2-Glycoprotein Level and Related Factors in Gestational Diabetes Mellitus

Background: Gestational diabetes mellitus (GDM), affecting up to 14% of pregnancies, is linked to obesity, sedentary lifestyle, and advanced maternal age. It is characterized by insulin resistance and adipose tissue inflammation. Zinc α-2-glycoprotein (ZAG) promotes lipid metabolism and glucose utilization, potentially linking it to GDM pathophysiology.Objectives: To evaluate the association between serum ZAG levels and GDM.Materials and methods: This case-control study was conducted at Al-Emamein Al-Kadhimein Medical City, Baghdad, Iraq, and included 100 pregnant women (24–28 weeks gestation), equally divided into GDM cases and healthy controls. Data collection included interviews, clinical exams, oral glucose tolerance tests, and serum ZAG level measurements.Results: There were no statistically significant differences (P-value > 0.05) in age, body mass index, or parity between the GDM group and the control group. However, GDM was significantly associated with a family history of diabetes and a history of macrosomia (P-value < 0.05). Patients with GDM had significantly higher levels of fasting blood sugar, hemoglobin A1c, and two-hour postprandial glucose compared to the control group (P-value = 0.0001). Serum ZAG levels were significantly lower in the GDM group (40.49 ± 7.63 ng/mL) than in the control group (55.7 ± 10.96 ng/mL), with a statistically significant difference (P-value = 0.0001). A cutoff value of ≥ 50.5 ng/mL was identified for ZAG in distinguishing between the two groups.Conclusion: This study suggests a potential role of ZAG in glucose metabolism during pregnancy and highlights its possible utility as a biomarker for metabolic alterations in GDM. However, as a single-center study with a relatively small sample size, further research is warranted to validate these findings and assess the clinical relevance of ZAG in GDM.