Prediction of gestational diabetes mellitus in the first trimester: Comparison of C-reactive protein, fasting plasma glucose, insulin and insulin sensitivity indices

ÖZGÜ ERDİNÇ A. S., Yilmaz S., Yeral M. I., Seckin K. D., ERKAYA S., Danisman A. N.

Journal of Maternal-Fetal and Neonatal Medicine, cilt.28, sa.16, ss.1957-1962, 2015 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 28 Sayı: 16
  • Basım Tarihi: 2015
  • Doi Numarası: 10.3109/14767058.2014.973397
  • Dergi Adı: Journal of Maternal-Fetal and Neonatal Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1957-1962
  • Anahtar Kelimeler: Fasting plasma glucose, gestational diabetes mellitus, high sensitivity C-reactive protein, homeostatic model assessment, insulin
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: To develop a predictive index based on high sensitivity C-reactive protein (hs-CRP), fasting plasma glucose (FPG) and fasting plasma insulin (FPI) measurements for early diagnosis of gestational diabetes mellitus (GDM).Methods: Healthy pregnant women who were screened for GDM during their first antenatal visit were included in this retrospective cohort study. FPG, FPI and serum hs-CRP concentrations were measured between weeks 11 and 14. A two-step glucose challenge test was carried out between gestational weeks 24 and 28. Fasting glucose/insulin ratio (FIGR), Homeostatic Model Assessment Insulin Resistance (HOMA-IR), HOMA-β indices and Quantitative Insulin Sensitivity Check Index (QUICKI) were used to estimate insulin sensitivity and β-cell function.Results: Of the 450 women who were eligible for the study, 49 (11.2%) were diagnosed with GDM at weeks 24-28. The median FPG and hs-CRP levels were higher in the GDM diagnosed women compared to the others. Comparison of accuracy measures resulted in the highest specificity (87.2%; 95% CI 83.5-90.1) and diagnostic odds ratio (3.9; 95% CI 2.1-7.6) for hs-CRP.Conclusion: FPG and hs-CRP in the first trimester are correlated with later development of GDM in the pregnancy. In our study, FPG provided a better sensitivity while hs-CRP exhibited a better specificity for prediction of GDM.