Abstract
Objective:To investigate the association of first trimester serum uric acid levels with the development of gestational diabetes mellitus (GDM) in low-risk pregnant women.Materials and Methods:In this retrospective data analysis, the results of pregnant women who completed both first trimester biochemical panel and two-step GDM screening were compared with an age-, body mass index, and gestational age-matched control group. The women were grouped as either GDM or impaired glucose tolerance (IGT) according to 100-g oral glucose challenge results. Uric acid levels were compared between the groups and diagnostic utility was tested with receiver-operating characteristics curves.Results:Sixty-six women in GDM group and 358 women in the IGT group were compared against 202 healthy pregnant women. The groups did not differ significantly in terms of parity, pre-gestational body mass index and gestational age. Serum samples for uric acid levels were obtained. The mean serum uric acid levels were significantly higher in the GDM and IGT groups (5.95 mg/dL (±0.97 mg/dL) and 4.76 mg/dL (±1.51 mg/dL), respectively) compared with the control group (3.76 mg/dL (±1.07 mg/dL) (p<0.001). The area under the curve for uric acid levels was 0.92 (95% confidence interval 0.88-0.95) for diagnosis of GDM. At a diagnostic threshold of 3.95 mg/dL, uric acid levels predicted development of GDM with 60% specificity and 100% sensitivity.Conclusion:First trimester serum uric acid has a linear association with the development of GDM and IGT.
Highlights
Gestational diabetes mellitus (GDM) is a relatively common disorder of pregnancy
The twostep approach consists of a 50-g oral glucose challenge test (GCT) performed between the 24th and 28th weeks of gestation, followed by a 100-g oral GCT if the initial 50-g oral GCT serial glucose result is over 140 mg/dL
The results of the 100-g oral GCT revealed that 86 women had GDM and the remaining 410 women were diagnosed as having IGT
Summary
The prevalence of GDM ranges from 1 to 6% depending on the studied population[1,2]. A recent study by Koivunen et al[9] reported no benefit of broad screening on cesarean section rates and birthweight despite increased rates of GDM diagnosis, glucose-challenge test applications, and labor induction. Until the benefits of broad screening are established there is a need of a better risk assessment method. Uric acid has been investigated as a possible risk factor for the development of GDM. Several researchers reported an association of uric acid levels with development of GDM[10,11,12]. The aim of the current study was to investigate the association of first trimester serum uric acid levels with development of GDM in a population of low-risk pregnant women
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