Maged Ahmed Mohamed, Moety Ghada Abdel Fattah, Mostafa Walaa Ahmed, Hamed Dalia Ahmed
Obstetrics and Gynecology Department and.
J Matern Fetal Neonatal Med. 2014 Jul;27(11):1108-12. doi: 10.3109/14767058.2013.850489. Epub 2013 Oct 22.
To study various biomarkers in prediction of gestational diabetes mellitus (GDM).
Prospective observational study included 400 pregnant women. Maternal serum sex hormone binding globulin (SHBG), high-sensitive C-reactive protein (hs-CRP), uric acid, creatinine and albumin were measured before 15 weeks of gestation. Patients were followed-up for development of GDM.
A total of 269 women were eligible for analysis. GDM complicated 27 (10.03%) of pregnancies. Hs-CRP levels were significantly higher and SHBG levels were significantly lower among women who subsequently developed GDM compared with normoglycemics. Uric acid, albumin and creatinine levels were not significantly different between both groups. For prediction of GDM, hs-CRP at a cutoff value of 2.55 mg/l showed a sensitivity and a specificity of 89% and 55%, respectively. SHBG at a cutoff value of 211.5 nmol/l showed a sensitivity and a specificity of 85% and 37%, respectively. Low SHBG with high hs-CRP predicted GDM with a sensitivity and specificity of 74.07% and 75.62%, respectively with an overall accuracy of 75.46%.
Hs-CRP and SHBG are important early predictors of GDM. Adding SHBG to hs-CRP improves specificity and serves good overall accuracy. Uric acid, creatinine and albumin have no role in GDM prediction.
研究各种生物标志物在预测妊娠期糖尿病（GDM）中的作用。
前瞻性观察性研究纳入了400名孕妇。在妊娠15周前测定孕妇血清性激素结合球蛋白（SHBG）、高敏C反应蛋白（hs-CRP）、尿酸、肌酐和白蛋白。对患者进行随访，观察GDM的发生情况。
共有269名女性符合分析条件。27例（10.03%）妊娠合并GDM。与血糖正常的女性相比，随后发生GDM的女性hs-CRP水平显著升高，SHBG水平显著降低。两组间尿酸、白蛋白和肌酐水平无显著差异。对于GDM的预测，hs-CRP临界值为2.55mg/l时，敏感性和特异性分别为89%和55%。SHBG临界值为211.5nmol/l时，敏感性和特异性分别为85%和37%。低SHBG伴高hs-CRP预测GDM的敏感性和特异性分别为74.07%和75.62%，总体准确率为75.46%。
hs-CRP和SHBG是GDM重要的早期预测指标。将SHBG与hs-CRP联合使用可提高特异性并具有良好的总体准确率。尿酸、肌酐和白蛋白在GDM预测中无作用。
