Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Diabetes Investig. 2018 Jul;9(4):967-974. doi: 10.1111/jdi.12798. Epub 2018 Jan 28.
AIMS/INTRODUCTION: To determine whether maternal serum markers in the early second trimester are useful for prediction of gestational diabetes mellitus (GDM).
A total of 876 singleton pregnancies were recruited in the present study. Blood samples were collected during 16-20 gestational weeks. GDM women were diagnosed by an oral glucose tolerance test during 24-28 gestational weeks. A total of 56 women with GDM and 73 healthy pregnant women were selected. Maternal serum concentrations of placental protein 13 (PP13), pentraxin 3 (PTX3), soluble fms-like tyrosine kinase-1 (sFlt-1), myostatin and follistatin (FST) were detected at 16-20 weeks' gestation. All of these markers concentrations were expressed as multiples of the medians. The Mann-Whitney U-test was used for comparison of the multiples of the medians of different concentrations of these five serum markers between the GDM group and the control group. Receiver operating characteristic curve analysis was applied to assess the sensitivity and specificity of significant serum markers from a Mann-Whitney U-test comparison.
Compared with healthy pregnancies, the serum levels of PP13, PTX3, sFlt-1, myostatin and FST in the early second trimester were significantly increased in patients who had developed GDM late. In screening for GDM by PP13, PTX3, sFlt-1, myostatin and FST, the detection rates were 92.3, 94.9, 94.9, 92.5 and 92.3%, respectively at 80% specificity. PTX3 and sFlt-1 were the most sensitive markers.
Maternal serum markers including PP13, PTX3, sFlt-1, myostatin and FST increase in the early second trimester of women with GDM. These five markers, especially PTX3 and sFlt-1, could have the value of prediction for those patients who would develop GDM in the late second trimester.
目的/引言：确定早孕期中期的母体血清标志物是否可用于预测妊娠糖尿病（GDM）。
本研究共纳入 876 例单胎妊娠。在 16-20 孕周采集血样。在 24-28 孕周时，通过口服葡萄糖耐量试验诊断 GDM 女性。选择了 56 名 GDM 女性和 73 名健康孕妇。在 16-20 孕周时检测母体血清胎盘蛋白 13（PP13）、五聚素 3（PTX3）、可溶性 fms 样酪氨酸激酶-1（sFlt-1）、肌肉生长抑制素和滤泡抑制素（FST）的浓度。所有这些标志物的浓度均表示为中位数的倍数。Mann-Whitney U 检验用于比较 GDM 组和对照组中这 5 种血清标志物不同浓度中位数的倍数。采用受试者工作特征曲线分析 Mann-Whitney U 检验比较的显著血清标志物的灵敏度和特异性。
与健康妊娠相比，GDM 患者在早孕期中期的血清 PP13、PTX3、sFlt-1、肌肉生长抑制素和 FST 水平明显升高。在使用 PP13、PTX3、sFlt-1、肌肉生长抑制素和 FST 筛查 GDM 时，特异性为 80%时，检出率分别为 92.3%、94.9%、94.9%、92.5%和 92.3%。PTX3 和 sFlt-1 是最敏感的标志物。
GDM 孕妇在早孕期中期血清标志物包括 PP13、PTX3、sFlt-1、肌肉生长抑制素和 FST 增加。这 5 种标志物，尤其是 PTX3 和 sFlt-1，可能对那些在孕晚期会发生 GDM 的患者有预测价值。
