Hyperuricemia in Early Pregnancy A Marker for Gestational Diabetes Mellitus

Abstract

Aim: Our study aimed to examine prospectively whether serum uric acid levels (and hyperuricemia) in the first trimester is associated with subsequent development of GDM in a random sample of pregnant women attending Antenatal clinics in a busy General hospital in Hyderabad, India. Materials and Method: Two hundred and twenty five pregnant women (<20 weeks gestation) were included in the study. Baseline assessments included age, BMI, diet, parity and serum uric acid level. Subjects were reassessed at 24-28 weeks for Gestational Diabetes mellitus (GDM). Data was systematically recorded and analysed to test for associations of various parameters with GDM Results: The mean baseline serum uric acid level was 2.6mg/dL. 5.1% of the subjects developed GDM when assessed at 24-28 weeks. Although within the normal range, serum uric acid level did increase with age, as did the risk of GDM. Diet, socio-economic status and BMI were not associated with an increase of either serum uric acid level or the risk of GDM. The results showed a clear increase in the risk of GDM with increasing serum uric acid levels. A serum uric acid cut-off value 3.4mg/dl had a sensitivity of 90%, specificity of 95% and a negative predictive value of 99% for subsequent development of GDM. Conclusion: Our study reiterates the association of raised serum uric acid levels in early pregnancy as a risk factor for subsequent development of GDM in an Indian population. A cut off level of 3.4 mg/dL appears to have good sensitivity and specificity in identifying those patients who are most likely to develop GDM later in pregnancy. This, if replicated and confirmed, can have important therapeutic implications in helping identify and manage GDM early, and thus prevent adverse maternal and foetal complications.