Comparison of serum and urinary cortisol levels in women with gestational diabetes and healthy pregnant women

Document Type : Original Article


1 M.Sc. of Clinical Biochemistry, Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

2 PhD of Clinical Biochemistry, Department of Biologic, School of Science,Islamic Azad University of Ahar, Aahr, Iran

3 Internist, Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

4 M.Sc. of Epidemiology, Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

5 PhD student of Epidemiology, Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.


Introduction: Gestational diabetes is defined as carbohydrate intolerance with different severity which is first diagnosed or occurred during pregnancy. Pregnancy as a stressful situation increases the secretion of cortisol. Therefore, considering the relation between cortisol hormone and gestational diabetes, this study was performed with the aim to evaluate and compare serum and urinary cortisol levels in healthy pregnant women and women with gestational diabetes.
Methods: This cross-sectional study was performed on 42 women with Gestational Diabetes Mellitus and 42 healthy pregnant women who had referred to Kermanshah diabetic center in 2013. In 24th gestational weeks, 24-h urine sample and no fasting blood sample were provided to assess cortisol level. Data was analyzed using SPSS software (version 16) and statistical tests of independent-t, Pearson correlation, multivariate covariance analysis, and Mann-Whitney. PResults: According to multivariate analysis of covariance analysis, there was significant difference between serum and urinary cortisol levels in two groups of healthy pregnant women and women with gestational diabetes (P<0.001). In the evaluation of under the ROC curve, 0.855 was obtained for serum cortisol and 0.866 for urinary cortisol, and to diagnose the gestational diabetes, sensitivity and specificity of serum cortisol were obtained 79.5% and 82.9%, and sensitivity and specificity of urine cortisol 84.6 % and 90.2%, respectively.
Conclusion: Serum and urinary cortisol levels is significantly higher in women with gestational diabetes compared to healthy pregnant women. Perhaps with performing studies, these criteria can be used as a criterion to diagnose gestational diabetes. Urinary cortisol level with higher sensitivity and specificity and more non-invasive method is preferred to serum cortisol test.         


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