Objectives: To evaluate the first trimester maternal biomarkers for early pregnancy prediction of gestational diabetes mellitus (GDM). Methods: The study was a case-control study of healthy women with singleton pregnancies at the first trimester carried out at the Obstetrics and Gynecology Unit, Clinica Davila, Santiago, Chile. After obtaining informed consent, peripheral blood samples of pregnant women under 14 weeks of gestation were collected. At 24-28 weeks of pregnancy, women were classified as GDM (n=16) or controls (n=80) based on the results of a 75-g oral glucose tolerance test (OGTT). In all women, we measured concentrations of fasting blood glucose, insulin, glycated hemoglobin, uric acid, cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), triglycerides, aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase (AP), sex hormone-binding globulin (SHBG), adiponectin, tissue plasminogen activator (t-PA), leptin and placental growth factor (PGF). Results: The GDM group displayed an increased median concentration of cholesterol (P=0.04), triglycerides (P=0.003), insulin (P=0.003), t-PA (P=0.0088) and homeostatic model assessment (HOMA) (P=0.003) and an increased mean concentration of LDL (P=0.009) when compared to the control group. The receiver operating characteristic (ROC) curve for significant variables achieved an area under the curve (AUC) of 0.870, a sensitivity of 81.4% and a specificity of 80.0%. The OGTT was positive for GDM according to the IADPSG (International Diabetes in Pregnancy Study Group) criteria. Conclusion: Women who subsequently developed GDM showed higher levels of blood-borne biomarkers during the first trimester, compared to women who did not develop GDM. These data warrant validation in a larger cohort.
Bibliographical noteFunding Information:
Acknowledgments: We thank the Clinica Davila and the Obstetrics and Gynecology Department and Laboratory staff for their cooperation and for obtaining, storing and processing blood samples. We specially thank Stephanie Acuña from the Universidad of Los Andes Biology of Reproduction Laboratory for processing all the samples. Finally, we would like to acknowledge the contribution of Conicyt through regular FONDECYT code 1140119. Author contributions: Sebastian Illanes developed the original idea for the study, participated in the implementation, recruited patients and acquired the grant for funding. Paula Correa designed, coordinated and implemented the project; supervised the follow-up and evaluated the result and also wrote the report and submitted the article. Pia Venegas coordinated recruitment, interviewed and educated patients, recorded patient data, supervised sample extraction and follow-up and cooperated in results analysis. Yasna Palmeiro, Daniela Albers, Max Monckeberg and Gregory Rice participated in statistical analysis. Gregory Rice also supervised the manuscript development. Jorge Cortez, Jaime Roa, Manuel Schepeler and Eduardo Osorio recruited and followed-up patients. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Research funding: We acknowledge the funding from Conicyt CONICYT, MINSAL, Funder Id: 10.13039/501100002848. Grant Code FONIS SA133i20154. Employment or leadership: None declared. Honorarium: None declared. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
© 2019 2019 Walter de Gruyter GmbH, Berlin/Boston.
- IADPSG criteria
- gestational diabetes
- oral glucose tolerance test
- tissue plasminogen activator