A Study Over Thiol Disulfide Homeostasis in Cord Blood in Women With Gestational Diabetes

  • Lebriz Hale Aktun Department of Obstetrics and Gynecology, Istanbul Medipol University, Istanbul, Turkey
  • Yeliz Aykanat -
  • Özcan Erel -
  • Salim Neşelioğlu Department of Biochemistry, Medical School, Yıldırım Beyazıt University, Istanbul, Turkey
  • Oktay Olmuscelik Department of Obstetrics and Gynecology, Istanbul Medipol University, Istanbul, Turkey
Keywords: Thiol, GDM, Cord Blood


Objective: To gain insight into the effect of gestational diabetes mellitus (GDM) on cord blood dynamic thiol/disulfide homeostasis.Materials and methods: A prospective case-control study was carried out for 132 pregnant women (62 GDM, 70 controls). The cord blood samples were collected from all the participants, and the native thiol-disulfide exchanges were examined by means of an automated method enabling to measure thiol-disulfide balance. In addition to investigating shifts in thiol disulfide balance between GDM and healthy pregnancies, we sought to correlate the thiol / disulfide homeostasis parameters with other clinical and laboratory characteristics of patients with GDM and using insulin (n = 19) and on a diet only (n = 43).Results: Disulfide amounts, disulfide/native thiol and disulfide/total thiol rates increased (p < 0.001) while native thiol/total thiol decreased in the cord blood of infants born to diabetic mothers (p < 0.001). Furthermore, the patient group administered with insulin and diet only was compared. Disulfide, Disulfide/Native thiol*100, Disulfide/total thiol*100, Native/total thiol*100 differ significantly according to the results (p < 0.05). Disulfide, Disulfide / native thiol * 100, Disulfide/total thiol*100, HbA1c and 75gr are higher than those in patients who do not use insulin. Only Native/total thiol*100 values are higher in patients who use insulin than those who do not.Conclusion: This study suggests that the infants born to diabetic mothers are exposed to increased oxidative stress. In addition, the patients who use insulin better control their blood glucose, thus reducing the need of newborns for intensive care.


1. Fauci AS, Braunwald E, Kasper DI, Hauser SL, Longo DL, Jameson JL, et al Harrison's principles of Internal Medicine. 17th ed. New York: McGraw Hill Medical. 2008: 631.
2. Cunningham FG, Leveno KG, Bloom SL, Hauth JC, Gilsrab LC, Wenstrom KD. Williams Obstetrics.22nd ed. New York: McGraw Hill. 2005.; 1170–2.
3. Royal College of Obstetricians and Gynaecologists. Scientific advisory committee opinion paper. Diagnosis and Treatment of Gestational Diabetes 2011; 8, 2011.
4. Satman I, İmamoglu S, Yilmaz C, Salman S, et al .Treatment and follow-up guide of Turkish diagnosis of endocrinology and metabolism association of diabetes mellitus and its complications. 2018; 10th Ed. Ankara: Miki:170-5.
5. West IC.Radicals and oxidative stress in diabetes. Diabet Med 2000; 17:171-80.
6. Sen CK., Packer L. Thiol homeostasis and supplements in physical exercise. Am J Clin Nutr 2000; 72:653S–669S.
7. Jones DP., Liang Y. Measuring the poise of thiol/disulfide couples in vivo. Free Radic Biol Med. 2009; 47:1329–38.
8. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem 2014; 47:326–32.
9. Chianeh YR., Prabhu K. Protein thiols as an indicator of oxidative stress. Archives Medical Review Journal. 2014; 23:443–56.
10. Circu ML, Aw TY. Reactive oxygen species, cellular redox systems, and apoptosis. Free Radic Biol Med 2010; 48:749–62.
11. Yuksel M, Ates I, Kaplan M, Alisik M, Erel O, Saygili F et al. The dynamic thiol/disulphide homeostasis in inflammatory bowel disease and its relation with disease activity and pathogenesis. Int J Colorectal Dis 2016; 31:1229–31.
12. Görlach A, Dimova EY, Petry A, Martínez-Ruiz A, Hernansanz-Agustín P, RoloAP,et al. Reactive oxygen species, nutrition, hypoxia and diseases: Problems solved? Redox Biol 2015; 6:372-85.
13. Dirican N, Dirican A, Sen O, Aynali A, Atalay S, Bircan HA, et al. Thiol/disulfide homeostasis: a prognostic biomarker for patients with advanced non-small cell lung cancer? Redox Rep 2016; 21:197–203.
14. Dumlu EG, Tokaç M, Bozkurt B, Yildirim MB, Ergin M, Yalcin A, et al. Correlation between the serum and tissue levels of oxidative stress markers and the extent of inflammation in acute appendicitis. Clinics (Sao Paulo) 2014; 69:677–82.
15. Matteucci E, Giampietro O. Thiol signaling network with an eye to diabetes. Molecules 2010; 15:8890–903.
16. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33:676–2.
17. Griffin ME, Coffery M, Johnson H, Scanlon P, Foley M, Stronge J, et al. Universal vs., risk factor-based screening for gestational diabetes mellitus: Detection rates, gestation at diagnosis and outcome. Diabet Med 2000; 17:26–32.
18. American Diabetes Association. Gestational diabetes mellitus. Diabetes Care. 2003; 26:S103–S105.
19. American Diabetes Association. Diagnosis and classification of diabetes mellitus.Diabetes Care. 2007; 30:S42–7.
20. Biri A, Onan A, Devrim E, Babacan F, Kavutcu M, Durak I. Oxidant status in maternal and cord plasma and placental tissue in gestational diabetes. Placenta 2006; 27:327–32.
21. Madazli R, Tuten A, Calay Z, Uzun H, Uludag S, Ocak V. The incidence of placental abnormal- ities, maternal and cord plasma malondialdehyde and vascular endothelial growth factor levels in women with gestational diabetes mellitus and nondiabetic controls. Gynecol Obstet Invest 2008; 65:227–32.
22. Ates I, Kaplan M, Inan B, Alısık M, Erel O, Yilmaz N, Guler S. How does thiol/disulfide home- ostasis change in prediabetic patients? Diabetes Res ClinPract 2015; 110:166-71.
23. Harper LM, Tita A, Biggio JR. The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes. Am J Perinatol 2015 ; 32: 239-46.
24. Ozler S, Oztasa E, Erelb O, Gumus BG, Ergind M, Uygura D, et al.Impact of Gestational Diabetes Mellitus and Maternal Obesity on Cord Blood Dynamic Thiol/Disulfide Homeostasis.Fetal and pediatric Pathology 2017;36:,8-15.
25. Ozler S, Oztaş E, Cağlar AT, Ergin M , Erel O, Danışman N. Thiol/disulfide homeostasis in predicting adverse perinatal outcomes at 24-28 weeks of pregnancy in gestational diabetes, The Journal of Maternal-Fetal & neonatal Medicine2016; 29: 3699-704.
26. Sapienza AD, Francisco RP, Trindade TC, Zugaib M. Factors predicting the need for insulin therapy in patients with gestational diabetes mellitus. Diabetes Res Clin Pract 2010; 88: 81–6.
27. Wong VW, Jalaludin B. Gestational diabetes mellitus: who requires insulin therapy? Aust N Z J Obstet Gynaecol 2011; 51: 432–6.
How to Cite
Aktun L, Aykanat Y, Erel Özcan, Neşelioğlu S, Olmuscelik O. A Study Over Thiol Disulfide Homeostasis in Cord Blood in Women With Gestational Diabetes. J Fam Reprod Health. 12(4):217-222.
Original Articles