Meta-analysis of Irisin Levels in Gestational Diabetes Mellitus
Keywords:Irisin, Myokine, Adipokine, GDM, Obesity
Background: Irisin is known as a miracle myo-adipokine that is secreted by skeletal muscle and fat tissue that increases insulin sensitivity. Current literature supports its role as a pathogenic agent in development of gestational diabetes; however, others have reported little or no difference between the two groups. Therefore, this meta-analysis aims to compare Irisin levels in gestational diabetes mellitus (GDM) pregnancies and non-GDM control pregnancies. A detailed literature search was carried via electronic databases, such as Medline, PubMed, and EMBase, for current related papers dating from January 1, 2017 over the last ten years. Only papers published in English were selected. Meta-analysis was preformed according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Effect size and relative weights for each study were estimated and results of individual and combined effect size were plotted in the forest plots. p values <0.05 were regarded to be significant. In most studies, irisin levels in GDM were significantly lower, as compared to the control group. This level favored development of GDM in these subjects. This was confirmed by the forest plot report and contour-enhanced funnel plot of trials compared the GDM and Control group for effect estimates and standard error [I-V pooled SMD -0.482 (95%CI -0.610 to -0.353); Heterogeneity Chi2 = 54.53 (d.f. = 7) p = 0.000; I2 (variation in SMD attributable to heterogeneity) = 87.2%; Test of SMD = 0: z =7.32 p =0.000]. Lower circulating Irisin can contribute to hyperglycemic disorders such as GDM, through a collective loss of its normal anti-diabetic mechanisms. This revelation paves the way for research into the use of recombinant Irisin as treatment or prevention of GDM, so that the prevalence of GDM and its maternal and fetal consequences may be reduced.