Gözükara Yavuz M, Aytan Hakan, Ertunc Devrim, Tok Ekrem C, Demirtürk Fazli, Şahin Şemsettin, Aytan Pelin
Department of Endocrinology, Ministry of Health Mersin Government Hospital, Mersin, Turkey.
J Obstet Gynaecol Res. 2015 Feb;41(2):193-8. doi: 10.1111/jog.12525. Epub 2014 Sep 26.
To assess the role of first trimester maternal testosterone and dehydroepiandrosterone sulfate (DHEA-S) levels in prediction of development of gestational diabetes mellitus (GDM).
Four hundred and fifty pregnant women were included in this prospective cohort study. All pregnant women with a singleton pregnancy who were not diabetic, had no family history of diabetes, had no history of previous GDM, were of white race and non-smokers were enrolled. Total testosterone and DHEA-S were measured at 11-14 weeks of gestation. The patients were called for routine pregnancy visits and followed accordingly. Forty-two patients did not come to their visits and were excluded. During gestational weeks 24-28, the remaining 408 patients were screened for GDM. The total testosterone and DHEA-S levels were compared between patients with and without GDM. Regression and receiver-operator curve analysis were performed.
GDM developed in 22 women (5.7%). Compared with women without GDM, first trimester total testosterone levels were higher among women in whom GDM subsequently developed. The DHEA-S level did not differ. Age, total testosterone and body mass index were found to be independent predictors of GDM development. A total testosterone value of 0.45 ng/mL was found to predict development of GDM with a sensitivity of 63.6% and a specificity of 62.7%.
First trimester total testosterone has a low testing power for GDM screening with low sensitivity and specificity values and cannot be used as a marker alone. It may have a role in combination with other markers.
评估孕早期母体睾酮和硫酸脱氢表雄酮（DHEA-S）水平在预测妊娠期糖尿病（GDM）发生发展中的作用。
本前瞻性队列研究纳入了450名孕妇。所有单胎妊娠、非糖尿病、无糖尿病家族史、无既往GDM史、白种人且不吸烟的孕妇均被纳入。在妊娠11 - 14周时测量总睾酮和DHEA-S。患者被要求进行常规产检并据此进行随访。42名患者未前来产检，被排除在外。在妊娠24 - 28周期间，对其余408名患者进行GDM筛查。比较发生GDM和未发生GDM患者的总睾酮和DHEA-S水平。进行回归分析和受试者操作特征曲线分析。
22名女性（5.7%）发生了GDM。与未发生GDM的女性相比，随后发生GDM的女性孕早期总睾酮水平更高。DHEA-S水平无差异。年龄、总睾酮和体重指数被发现是GDM发生发展的独立预测因素。发现总睾酮值为0.45 ng/mL时预测GDM发生的敏感性为63.6%，特异性为62.7%。
孕早期总睾酮对GDM筛查的检测效能较低，敏感性和特异性值较低，不能单独用作标志物。它可能与其他标志物联合发挥作用。
