Department of Science and Environment, Roskilde University, 4000 Roskilde, Denmark.
Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria.
Cells. 2021 Jan 15;10(1):170. doi: 10.3390/cells10010170.
Early identification of gestational diabetes mellitus (GDM) aims to reduce the risk of adverse maternal and perinatal outcomes. Currently, no circulating biomarker has proven clinically useful for accurate prediction of GDM. In this study, we tested if a panel of small non-coding circulating RNAs could improve early prediction of GDM. We performed a nested case-control study of participants from the European multicenter 'Vitamin D and lifestyle intervention for GDM prevention (DALI)' trial using serum samples from obese pregnant women (BMI ≥ 29 kg/m) entailing 82 GDM cases (early- and late- GDM), and 41 age- and BMI-matched women with normal glucose tolerance (NGT) throughout pregnancy (controls). Anthropometric, clinical and biochemical characteristics were obtained at baseline (<20 weeks of gestation) and throughout gestation. Baseline serum microRNAs (miRNAs) were measured using quantitative real time PCR (qPCR). Elevated miR-16-5p, -29a-3p, and -134-5p levels were observed in women, who were NGT at baseline and later developed GDM, compared with controls who remained NGT. A combination of the three miRNAs could distinguish later GDM from NGT cases (AUC 0.717, = 0.001, compared with fasting plasma glucose (AUC 0.687, = 0.004)) as evaluated by area under the curves (AUCs) using Receiver Operator Characteristics (ROC) analysis. Elevated levels of individual miRNAs or a combination hereof were associated with higher odds ratios of GDM. Conclusively, circulating miRNAs early in pregnancy could serve as valuable predictive biomarkers of GDM.
早期识别妊娠糖尿病（GDM）旨在降低不良母婴围产结局的风险。目前，尚无循环生物标志物被证明对 GDM 的准确预测具有临床应用价值。在这项研究中，我们测试了一组小非编码循环 RNA 是否可以改善 GDM 的早期预测。我们对来自欧洲多中心“维生素 D 和生活方式干预预防 GDM（DALI）”试验的参与者进行了嵌套病例对照研究，使用肥胖孕妇（BMI≥29kg/m）的血清样本，包括 82 例 GDM 病例（早发和晚发 GDM）和 41 例年龄和 BMI 匹配的整个孕期葡萄糖耐量正常（NGT）的女性（对照组）。在基线（<20 周妊娠）和整个孕期获得了人体测量、临床和生化特征。使用定量实时 PCR（qPCR）测量基线血清 microRNAs（miRNAs）。与在基线时 NGT 但后来发展为 GDM 的女性相比，在基线时 NGT 且后来仍保持 NGT 的女性中观察到 miR-16-5p、-29a-3p 和 -134-5p 水平升高。使用受试者工作特征（ROC）分析评估曲线下面积（AUC），由这三种 miRNAs 组成的组合可以将后来的 GDM 与 NGT 病例区分开来（AUC 0.717，=0.001，与空腹血浆葡萄糖（AUC 0.687，=0.004）相比）。单独的 miRNA 或其组合的升高水平与 GDM 的更高比值比相关。总之，妊娠早期的循环 miRNA 可作为 GDM 的有价值的预测生物标志物。
