Shanghai kou qiang yi xue = Shanghai journal of stomatology · 2007
[Development and clinical application of ultrasonic osteotomy in dentistry].
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Ben Kridis Wala, Hakim Mahmoud, Sakka Dhouha, Makni Saadia, Henteti Abdesslem, Chtourou Khalil, Boudawara Tahia, Khanfir Afef
Аннотация
PURPOSE: Gestational diabetes mellitus (GDM) is a metabolic disorder of pregnant women that develops during their second or third trimester. As an important organ in carbohydrate and lipid metabolism, the liver may play a role in GDM pathophysiology. This meta-analysis examined the conflicting relationship between liver enzyme levels and GDM risk while emphasizing the probable use of liver enzymes as a biomarker for early detection and prevention of GDM.
METHODS: Literature from PubMed, EBSCO, Google Scholar, and ScienceDirect was systematically reviewed through August 2025. A total of seven studies were included after meeting the inclusion criteria. The pooled data were converted to mean and SD, then analyzed with the random-effects model to estimate ORs with 95% CIs. ROC curves were generated to determine the AUC and evaluate the diagnostic performance of liver enzymes. Subgroup analyses were made based on ethnicity and timing of the enzyme test.
RESULTS: ALT (SMD = 1.11; 95% CI: 0.72-1.49; p < 0.00001) and GGT (SMD = 0.79; 95% CI: 0.48-1.09; p < 0.00001) levels were markedly elevated in women who developed GDM. AST did not differ significantly between the GDM and non-GDM groups (SMD = -0.15; 95% CI: -0.66-0.37; p = 0.57). However, there is high heterogeneity in all three analyses. Subgroup analyses showed ALT levels to be significantly elevated among Asian women with GDM (SMD = 0.92; 95% CI: 0.49-1.35; p < 0.0001) and among women who were assessed during early pregnancy (SMD = 1.29; 95% CI: 0.88-1.69; p < 0.00001). ROC curve analyses revealed that ALT (AUC = 0.755) and GGT (AUC = 0.778) have a fair ability to differentiate GDM cases.
CONCLUSION: This meta-analysis further elaborated the potential of ALT and GGT enzyme tests during early pregnancy as markers for identifying women at risk. However, AST did not have a significant correlation in this case. These findings further suggest the need to evaluate the connection between hepatic alterations and the onset of GDM.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-026-01977-6.
METHODS: Literature from PubMed, EBSCO, Google Scholar, and ScienceDirect was systematically reviewed through August 2025. A total of seven studies were included after meeting the inclusion criteria. The pooled data were converted to mean and SD, then analyzed with the random-effects model to estimate ORs with 95% CIs. ROC curves were generated to determine the AUC and evaluate the diagnostic performance of liver enzymes. Subgroup analyses were made based on ethnicity and timing of the enzyme test.
RESULTS: ALT (SMD = 1.11; 95% CI: 0.72-1.49; p < 0.00001) and GGT (SMD = 0.79; 95% CI: 0.48-1.09; p < 0.00001) levels were markedly elevated in women who developed GDM. AST did not differ significantly between the GDM and non-GDM groups (SMD = -0.15; 95% CI: -0.66-0.37; p = 0.57). However, there is high heterogeneity in all three analyses. Subgroup analyses showed ALT levels to be significantly elevated among Asian women with GDM (SMD = 0.92; 95% CI: 0.49-1.35; p < 0.0001) and among women who were assessed during early pregnancy (SMD = 1.29; 95% CI: 0.88-1.69; p < 0.00001). ROC curve analyses revealed that ALT (AUC = 0.755) and GGT (AUC = 0.778) have a fair ability to differentiate GDM cases.
CONCLUSION: This meta-analysis further elaborated the potential of ALT and GGT enzyme tests during early pregnancy as markers for identifying women at risk. However, AST did not have a significant correlation in this case. These findings further suggest the need to evaluate the connection between hepatic alterations and the onset of GDM.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-026-01977-6.