Likewise, according to other studies, ferritin level is also in consistence with body iron stores and, therefore, is the most appropriate laboratory indicator Perifosine for the estimation of iron stores.[2] Hence, serum ferritin measurement is recommended for the evaluation of body iron status. Based on other reports, high iron level in the body has been suggested as a risk factor for developing GDM.[13,19,20] Administration of iron supplements along with vitamin C in women with sufficient levels of iron stores contributes to free radical overproduction, lipid membrane damage, delayed growth and increased carcinogenesis.[26] In addition, increased iron administration affects insulin secretion and increases lipid oxidation and leads to decrement in muscle glucose uptake and consumption and increment in gluconeogenesis in liver, resulting in enhanced sensitivity to insulin and predisposition to GDM.

[27] Elevated serum ferritin concentration, which is associated with insulin resistance and diabetes in the general population, has also been recently reported in gestational diabetes.[19,20,28,29] In some studies, iron level augmentation has been identified as a harmful factor for the body through oxidative stress and free radicals.[30,31] Excess iron and oxidative stress play a role in the pathogenesis and increased risk of type II diabetes and other associated disorders. Recently, it has been clear that iron influences glucose metabolism even in the absence of excess iron.

The surveys have displayed that body iron stores are involved in impaired glucose tolerance and gestational diabetes, because iron compounds can affect insulin synthesis and secretion, increased lipid oxidation and subsequent reduction in glucose transport into the muscle and elevation in gluconeogenesis, and as a result, eventuate in insulin resistance in tissues.[28,16,32] Iron has a role in diabetes development via three mechanisms: (1) decreased insulin production, (2) increased resistance to insulin and (3) causing liver dysfunction.[33] Body mass index is another risk factor for the development of gestational diabetes; this indicator has been significantly higher in women with GMD than healthy pregnant women (P < 0.000), and for per-unit increase in BMI, the risk of gestational diabetes even after neutralizing effect of ferritin was significantly increased by 1 percent, which is consistent with other studies.

[34,35] Wrede et al. also reported that serum ferritin is significantly increased in men and women with a BMI >25 kg/m2.[36] Regarding Brefeldin_A the study findings and in comparison with similar researches, it seems that routine administration of iron supplements to all pregnant women needs more investigation, since a significant relationship has been found between diabetes and increased serum ferritin level.