Department of Obstetrics and Gynecology, Umraniye Training and Research Hospital, Istanbul, Turkey.
J Matern Fetal Neonatal Med. 2023 Dec;36(2):2254889. doi: 10.1080/14767058.2023.2254889.
We aimed to investigate the maternal serum endocan concentrations in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM) and to investigate the usability of serum endocan in GDM screening.
This prospective case-control study was conducted with 160 pregnant women. The GDM group consisted of 80 pregnant women who had 75 g OGTT between the 24th and 28th weeks of pregnancy and were diagnosed with GDM. The control group consisted of 80 healthy pregnant women who were matched with the GDM group in terms of age and body mass index (BMI) and had a normal 75 g OGTT result. Serum endocan concentrations were evaluated between 24 and 28 weeks of gestation in all participants and the groups were compared in terms of serum endocan concentrations.
The median maternal serum endocan concentration was found to be significantly higher in the GDM group than in the control group (498 ng/L, and 467 ng/L, respectively, = 0.024). In the subgroup analysis according to the BMI of the participants, the highest median maternal serum endocan concentration (513 ng/L) was found in the overweight GDM group. ROC analysis was performed to determine the value of maternal serum endocan concentration in predicting GDM. AUC analysis of maternal serum endocan for estimation of GDM was 0.603 ( = 0.024, 95% CI = 0.515 - 0.691). The optimal threshold value for maternal serum endocan concentration was determined as 376 ng/L with 88.75% sensitivity and 32.5% specificity.
Although serum endocan does not have high enough specificity to be used as an alternative to OGTT in GDM screening between 24 and 28 weeks of gestation, we think that it is somehow involved in the pathogenesis of GDM. The contribution of placental endocan expression to the serum concentration and the effect of blood glucose regulation on serum endocan concentration in GDM remain to be investigated.
本研究旨在探讨妊娠期糖尿病（GDM）孕妇血清内脂素浓度，并评估其在 GDM 筛查中的应用价值。
本前瞻性病例对照研究纳入了 160 名孕妇。GDM 组 80 例孕妇于妊娠 24 至 28 周行 75g 口服葡萄糖耐量试验（OGTT），根据 OGTT 结果诊断为 GDM；对照组 80 例健康孕妇与 GDM 组孕妇年龄和体质量指数（BMI）匹配，且 75g OGTT 结果正常。所有参与者均于妊娠 24 至 28 周检测血清内脂素浓度，并比较两组间血清内脂素浓度。
GDM 组孕妇血清内脂素浓度中位数显著高于对照组（分别为 498ng/L 和 467ng/L， = 0.024）。根据参与者 BMI 的亚组分析，超重 GDM 组孕妇的血清内脂素浓度中位数最高（513ng/L）。为确定血清内脂素浓度预测 GDM 的价值，我们进行了 ROC 分析。血清内脂素对 GDM 的 AUC 分析为 0.603（ = 0.024，95%CI=0.515-0.691）。血清内脂素浓度的最佳截断值确定为 376ng/L，其灵敏度为 88.75%，特异性为 32.5%。
虽然血清内脂素在 24 至 28 周妊娠时的 GDM 筛查中特异性不够高，不能替代 OGTT，但我们认为其可能与 GDM 的发病机制有关。胎盘内脂素表达对血清浓度的影响以及 GDM 患者血糖调节对内脂素浓度的影响尚待进一步研究。
