The Mo-Se-Fe-NOS Signature: Linking trace Element Dysregulation to Endothelial Dysfunction in Gestational Diabetes Mellitus.

OBJECTIVE

Gestational diabetes mellitus (GDM) is a multifactorial metabolic disorder in which redox imbalance and endothelial dysfunction may contribute to adverse maternal-fetal outcomes. We investigated whether maternal serum essential and toxic element profiles differ in GDM and whether these alterations are associated with oxidative stress indices and nitric oxide (NO) bioavailability.

METHODS

Serum samples from 50 women with GDM and 50 healthy pregnant controls were analyzed. Essential trace elements (Zn, Cu, Se, Fe, Mn, Cr, Mo, V) and toxic metals (Pb, Cd, As, Sn, Co) were quantified using inductively coupled plasma mass spectrometry (ICP-MS). Total antioxidant status (TAS), total oxidant status (TOS), asymmetric dimethylarginine (ADMA), and nitric oxide synthase (NOS)-related NO metabolites were measured by ELISA-based methods.

RESULTS

NOS levels were significantly reduced in GDM (p < 0.001), while TAS, TOS, and ADMA did not differ between groups. Zn, Cu, Se, Fe, Mo, and V were significantly higher in GDM, whereas toxic metals showed no group differences. In exploratory ROC analyses, selenium showed the highest discrimination for GDM (AUC = 0.754, p < 0.001), followed by iron (AUC = 0.714, p < 0.001) and vanadium (AUC = 0.700, p = 0.001). Molybdenum demonstrated modest discrimination (AUC = 0.662, p = 0.005), indicating potential-rather than strong stand-alone-predictive value. In logistic regression (per 1 SD increase), selenium and molybdenum were associated with higher odds of GDM in age-adjusted models, supporting the relevance of the multi-marker profile.

CONCLUSION

The co-occurrence of elevated redox-active elements with reduced NO bioavailability in GDM supports a hypothesis-generating "Mo-Se-Fe-NOS signature" (an observational multi-marker profile) that warrants longitudinal and external validation to clarify mechanisms and clinical utility.