Glycosylated Fibronectin as a First-Trimester Biomarker for Prediction of Gestational Diabetes

• DOI: 10.1097/aog.0b013e3182a0c88b
• Publication Date: 2013-08-06T19:52:01Z
• Authors: Juha P. Rasanen; Caryn K. Snyder; Paturi V. Rao; Raluca Mihalache; Seppo Heinonen; Michael G. Gravett; Charles T. Roberts; Srinivasa R. Nagalla
• Keywords: Human placental lactogen

In Brief OBJECTIVE: To evaluate the potential clinical utility of serum biomarkers for first-trimester prediction gestational diabetes mellitus (GDM). METHODS: Maternal concentrations glycosylated (Sambucus nigra lectin–reactive) fibronectin, adiponectin, sex hormone–binding globulin, placental lactogen, and high-sensitivity C-reactive protein (CRP) were measured at 5–13 weeks gestation in a case-control study 90 pregnant women with subsequent development GDM 92 control group participants. Ability to detect was assessed using logistic regression modeling receiver operating characteristic (ROC) curves. Classification performance positive negative predictive values reported specific thresholds. Glycosylated fibronectin variation across trimesters evaluated serial-measures analysis 35 nondiabetic RESULTS: First-trimester CRP, lactogen significantly associated (P<.001) GDM. After adjustment maternal factors other biomarkers, demonstrated an independent association (P<.001). Adiponectin, modest classification compared (respectively: area under curve [AUC] 0.63; 95% confidence interval [CI] 0.53–0.71; AUC 0.68; CI 0.60–0.76; 0.67, 0.59–0.75; 0.91; 0.87–0.96). levels above threshold 120 mg/L correctly identified 57 case participants value 63% (95% 53–72%) 94–95%) population prevalence 12%. There no between globulin CONCLUSION: is pregnancy-specific biomarker early identification risk LEVEL OF EVIDENCE: II Elevated are as determined by oral glucose tolerance test.