4.0 Article

Prediction of gestational diabetes mellitus in the first trimester: comparison of maternal fetuin-A, N-terminal proatrial natriuretic peptide, high-sensitivity C-reactive protein, and fasting glucose levels

Journal

ARCHIVES OF ENDOCRINOLOGY METABOLISM
Volume 63, Issue 2, Pages 121-127

Publisher

SBEM-SOC BRASIL ENDOCRINOLOGIA & METABOLOGIA
DOI: 10.20945/2359-3997000000126

Keywords

Gestational diabetes; first trimester screening; fetuin-A; N-terminal peptide of proatrial natriuretic peptide; high sensitivity C-reactive protein; fasting plasma glucose

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Objective: We investigated the utility of maternal fetuin-A, N-terminal proatrial natriuretic peptide (pro-ANP), high-sensitivity C-reactive protein (hs-CRP), and fasting glucose levels at 11-14 gestation weeks for predicting pregnancies complicated by gestational diabetes mellitus (GDM). Subjects and methods: This prospective cohort study included 327 low-risk pregnant women who completed antenatal follow-up at a tertiary research hospital between January and April 2014. Maternal blood samples were collected between 11-14 gestational weeks in the first trimester of pregnancy and then stored at-80 degrees C until further analyses. During follow-up, 29 (8.8%) women developed GDM.The study population was compared 1:2 with age- and body mass index-matched pregnant women who did not develop GDM (n = 59). Fasting plasma glucose (FPG) levels and serum fetuin-A, pro-ANP, and hs-CRP levels were measured using automated immunoassay systems. Results: There was a significant negative correlation between fetuin-A and hs-CRP (CC = -0.21, p = 0.047) and a positive correlation between FPG and hs-CRP (CC = 0.251, p = 0.018).The areas under the receiver operating characteristic curve for diagnosing GDM were 0.337 (p= 0.013), 0.702 (p= 0.002), and 0.738 (p < 0.001) for fetuin-A, hs-CRP, and FPG, respectively.The optimal cut-off values were > 4.65, < 166, and > 88.5 mg/dL for maternal hs-CRP, fetuin-A, and FPG, respectively. Conclusion: Reduced fetuin-A, elevated hs-CRP, and FPG levels in women in the first trimester can be used for the early detection of GDM. Further research is needed before accepting these biomarkers as valid screening tests for GDM.

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