Evaluation of serum zonulin for use as an early predictor for gestational diabetes

K Mokkala,T Vahlberg,K Laitinen,K Tertti,T Rönnemaa

doi:10.1038/nutd.2017.9

Abstract

Diet has an important role in regulating intestinal permeability and subsequently the risk for metabolic disorders. In this observational study, we examined whether serum intestinal permeability marker zonulin, could be used as a predictor for gestational diabetes mellitus (GDM). Serum zonulin concentration was measured in early pregnancy in overweight or obese pregnant women (n=88) at risk for developing GDM. Serum zonulin was associated with higher odds of GDM (adjusted OR for 1 ng ml−1 increase in zonulin: 1.08, 95% CI: 1.02–1.15; P=0.009), diagnosed by a 2-h 75-g oral glucose tolerance test at late pregnancy. The optimal cutoff value was 43.3 ng ml−1, with sensitivity of 88% (95% CI: 71–100%) and specificity of 47% (95% CI: 33–58%). The area under the ROC-curve was 0.67 (95% CI: 0.54–0.81). Our results show an association between increased early-pregnancy serum zonulin concentration and GDM, suggesting zonulin as a possible predictor for GDM.

Highlights

Diet and lifestyle, obesity, are well-established risk factors for gestational diabetes (GDM)
We investigated whether an increased serum zonulin concentration could be used as a tool to predict gestational diabetes mellitus (GDM) in early pregnancy, as reliable markers are lacking
The association between serum zonulin and GDM was analyzed with binary logistic regression after adjustment for body mass index (BMI), previous GDM (n = 5), diagnosis of type 2 diabetes or metabolic syndrome of the parents of the mother and study group of the original intervention setting

Summary

Introduction

Obesity, are well-established risk factors for gestational diabetes (GDM). We investigated whether an increased serum zonulin concentration could be used as a tool to predict GDM in early pregnancy, as reliable markers are lacking. In high-risk mothers (n = 25) the OGTT was performed already at 14 (s.d.: 2) weeks of gestation (early-pregnancy OGTT) and if negative retest was performed at midpregnancy.

Results

Conclusion