Comparison of WNT1-Inducible Signaling Pathway Protein 1 Levels in Gestational Diabetes Mellitus and Normoglycaemic Pregnancy: A Cross-sectional Study

Introduction: Gestational Diabetes Mellitus (GDM) is a common condition that occurs in pregnancy with adverse outcomes. The Wingless and Int-1 ( WNT) signaling pathway is related to adipogenesis as well as inflammatory processes during pregnancy. WNT Inducible Signaling Pathway Protein 1 (WISP-1) has recently been described as a novel adipokine, which may participate in impaired glucose homeostasis. WISP-1 plays a critical part in the pathogenesis of obesity- and inflammationrelated diseases. Aim: To estimate WISP 1 levels and their association with hepatic steatosis and insulin resistance in GDM. Materials and Methods: The present cross-sectional study was conducted in the Obstetrics Antenatal Outpatient Department (OPD) of SRM Medical College Hospital and Research Centre, Kattankulathur, Chengalpattu District, Tamil Nadu, India, from December 2023 to May 2024. A total of 41 GDM patients and 41 normal healthy pregnant women between 12 to 28 weeks of pregnancy were included. Pregnant women were diagnosed as GDM, based on the Diabetes in Pregnancy Study Group India criteria (DIPSI). The biochemical analytes such as fasting plasma glucose, Glucose Challenge Test (GCT), Total Cholesterol (TC), Triglycerides (TGL), Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), Aspartate Transaminase (AST), Alanine Transaminase (ALT), Hepatic Steatosis Index (HSI), WISP-1 and C-peptide levels were analysed. C-peptide derived C-Peptide Immunoreactivity Insulin Resistance (CPRIR) index, C-peptide based Homeostatic Model Assessment of Insulin Resistance (HOMA-IR CP) was calculated. Independent t-test was used for normal distribution and data was presented as mean±SD or the Mann-Whitney U test for skewed data and data presented as median (interquartile range). Correlation analysis was performed using Spearman’s correlation between parameters in GDM group. Statistical significance was defined as probability value, p<0.05. Results: The mean age was 27.17 years in GDM group while in the control group it was 25.58 years. WISP 1 levels were found to be increased in GDM patients, 114.54 (69.29, 174.7) compared to healthy pregnant women, 95.5 (67.39, 160.76), but this difference was not statistically significant (p=0.366). C peptide 0.46 (0.27, 0.88), HOMA-IR CP 1.51 (1.51, 1.53) were found to be significantly increased in GDM patients. WISP-1 does not correlate with hepatic steatosis (ρ=-0.207, p=0.193) and insulin resistance based on C peptide (ρ=-0.219, p=0.170) in GDM patients. Conclusion: WISP-1 has no correlation with hepatic steatosis and insulin resistance based on C peptide in GDM patients.