Bogdanet Delia, Toth Castillo Michelle, Doheny Helen, Dervan Louise, Luque-Fernandez Miguel-Angel, Halperin Jose A, O'Shea Paula M, Dunne Fidelma P
College of Medicine, Nursing and Health Sciences, School of Medicine, National University of Ireland, H91 TK33 Galway, Ireland.
Divisions of Haematology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
J Clin Med. 2022 Jul 4;11(13):3895. doi: 10.3390/jcm11133895.
The aim of this study was to evaluate the ability of second trimester plasma glycated CD59 (pGCD59), a novel biomarker, to predict the results of the 2 h 75 g oral glucose tolerance test at 24−28 weeks of gestation, employing the 2013 World Health Organisation criteria. This was a prospective study of 378 pregnant women. The ability of pGCD59 to predict gestational diabetes (GDM) was assessed using adjusted ROC curves for maternal age, BMI, maternal ethnicity, parity, previous GDM, and family history of diabetes. The pGCD59 levels were significantly higher in women with GDM compared to women with normal glucose tolerance (p = 0.003). The pGCD59 generated an adjusted AUC for identifying GDM cases of 0.65 (95%CI: 0.58−0.71, p < 0.001). The pGCD59 predicted GDM status diagnosed by a fasting glucose value of 5.1 mmol/L with an adjusted AUC of 0.74 (95%CI: 0.65−0.81, p < 0.001). Analysis of BMI subgroups determined that pGCD59 generated the highest AUC in the 35 kg/m2 ≤ BMI < 40 kg/m2 (AUC: 0.84 95%CI: 0.69−0.98) and BMI ≥ 40 kg/m2 (AUC: 0.96 95%CI: 0.86−0.99) categories. This study found that second trimester pGCD59 is a fair predictor of GDM status diagnosed by elevated fasting glucose independent of BMI and an excellent predictor of GDM in subjects with a very high BMI.
本研究旨在采用2013年世界卫生组织标准，评估孕中期血浆糖化CD59（pGCD59，一种新型生物标志物）预测妊娠24 - 28周时75克口服葡萄糖耐量试验2小时结果的能力。这是一项对378名孕妇的前瞻性研究。使用针对孕妇年龄、体重指数（BMI）、种族、产次、既往妊娠糖尿病（GDM）和糖尿病家族史进行调整的ROC曲线，评估pGCD59预测GDM的能力。与糖耐量正常的女性相比，GDM女性的pGCD59水平显著更高（p = 0.003）。pGCD59识别GDM病例的调整后曲线下面积（AUC）为0.65（95%置信区间：0.58 - 0.71，p < 0.001）。pGCD59预测空腹血糖值为5.1 mmol/L诊断的GDM状态，调整后AUC为0.74（95%置信区间：0.65 - 0.81，p < 0.001）。对BMI亚组的分析确定，pGCD59在35 kg/m2≤BMI < 40 kg/m2（AUC：0.84，95%置信区间：0.69 - 0.98）和BMI≥40 kg/m2（AUC：0.96，95%置信区间：0.86 - 0.99）类别中产生的AUC最高。本研究发现，孕中期pGCD59是空腹血糖升高诊断的GDM状态的良好预测指标，独立于BMI，并且是BMI非常高的受试者中GDM的优秀预测指标。
