Searching for optimal serum marker for early prediction of gestational diabetes

ABSTRACT

To examine which serum marker [sex hormone binding globulin [SHBG], C-reactive protein [CRP], insulin. glucose] is accurate in early predicting the occurrence of GDM. One hundred and fifty six pregnant mothers high risk to develop gestational diabetes mellitus [GDM] were included in the study. When GDM was excluded at hooking setting [using OGTT], mothers are candidate for assaying fasting and non fasting sex hormone binding globulin [SHBO], fasting and non fasting quantitative C-reactive protein [CRP] and fasting insulin levels [from the same blood samples withdrawn during performing the OGTT], OGTT was repeated at 28 weeks and 36 weeks of gestation to diagnose GDM. According to the results of follow up OGTT, participant were divided into cases who developed GDM and those who did not develop GDM to assess the accuracy of each of the studied markers in predicting the occurrence of 0DM in high risk mothers. Sex hormone binding globulin levels [fasting and non fasting] were significantly lower among women who subsequently developed GDM compared with the control group [[276.9 +/- 78.7nmol/L vs 322.4 +/- 71.6nmol/L, P=0.001], [261.5 +/- 66.7 nmol/L vs 299 +/- 59.7 nmol/L, P0.00l] respectively]. No difference was detected in C-reactive protein levels [fasting and non lasting] [P=0.33, 0.349], fasting insulin [P0.082], lasting glucose levels [P=0.119], between the study group who subsequently developed GDM and the control group. SHBG can he used as an early marker to identify the group at highest risk for subsequent GDM allowing earlier intervention and possible benefits to the mothers and their offspring