Gestational Diabetes Mellitus (GDM) has high prevalence affecting 1 in 6 pregnancies worldwide. There is growing evidence that women developing GDM earlier in pregnancy are more likely to have adverse maternal and neonatal outcomes, which predisposes their offspring to diabetes and obesity.
We assessed pGCD59 as an early predictor (<20 weeks’ gestation) of GDM and its associated complications. To that end, we conducted a retrospective case-control study from a pan European trial of obese women. We measured and analyzed pGCD59 in frozen plasma samples from =800 pregnant women. The results show that maternal pGCD59 accurately identified GDM in early pregnancy. One-unit increase in maternal pGCD59 level in early pregnancy was associated with 30% increased odds of delivering a large for gestational age infant and 60% higher odds of delivering an infant with congenital malformations, neonatal hypoglycemia or both.
Our study indicates a single measurement of pGCD59 in the first trimester of pregnancy may simplify screening and accurately diagnose GDM. Further, it may potentially characterize “sub- threshold” glucose intolerance in pregnant women who are currently classified as “normal” by glucose load tests and may benefit from closer monitoring and treatment to prevent potentially serious maternal and neonatal complications of GDM.
Objectives: Gestational diabetes mellitus (GDM) is a health care challenge because of increased risk of adverse pregnancy outcomes. Plasma-glycated CD59 (pGCD59) is an emerging biomarker for diabetes and GDM. The aim of this study was to assess the performance of pGCD59 as a biomarker of early GDM and its associated complications.
Methods: Blood levels of pGCD59 were measured in samples from 693 obese women undergoing a 75-g, 2-hour oral glucose tolerance test (OGTT) at <20 weeks gestation in the Vitamin D and Lifestyle Intervention (DALI) study: the main analyses included 486 subjects who had normal OGTT and 207 who met criteria for GDM at <20 weeks, and 77 diagnosed with GDM at second trimester.
Reference tests: OGTT adjudicated based on the IADPSG criteria. Index test: pGCD59 ELISA.
Results: pGCD59 accurately identified GDM in early pregnancy (AUCROC curves: 0.86, 95% CI: 0.83-0.90). One-unit increase in maternal pGCD59 level was associated with 36% increased odds of delivering an LGA infant, 60% higher odds of a combined neonatal outcome composed of congenital malformations and neonatal hypoglycemia.
Conclusion: Our results indicate that pGCD59 is a simple and accurate biomarker for detection of GDM in early pregnancy and risk assessment of adverse neonatal complications.
Keywords: biomarkers; GDM; glycation; prediction.