The utility of plasma glycated CD59 in predicting postpartum glucose intolerance: a prospective study of women diagnosed with GDM during a period of universal GDM screening.

Abstract

Gestational diabetes (GDM) is associated with the development of postpartum (PP) glucose intolerance. Plasma glycated CD59 (pGCD59) is an emerging biomarker for the detection of hyperglycaemia. The aim of this study was to assess the ability of PP pGCD59 to predict the development of PP GI as defined by the 2h 75 g OGTT using the ADA criteria, in a cohort of women diagnosed with prior GDM in the index pregnancy using the 2h 75 g OGTT at 24-28 weeks of gestation according to the World Health Organisation (WHO) 2013 criteria METHODS: Of the 2017 pregnant women recruited prospectively 140 women with gestational diabetes had samples for pGCD59 taken PP at the time of the OGTT. The ability of pGCD59 to predict the results of the PP OGTT was assessed using nonparametric receiver operating characteristic (ROC) curves. Women with PP glucose intolerance had significantly higher PP pGCD59 levels compared to women with normal glucose tolerance PP (3.8 vs 2.7 SPU). PP pGCD59 identified women who developed glucose intolerance PP with an AUC of 0.80 (95% CI:0.70-0.91). A PP pGCD59 cut-off value of 1.9 SPU generated a sensitivity of 100% (95%CI:83.9-100), specificity of 16.9% (95%CI:9.8-26.3), positive predictive value of 22.1% (95%CI:21.0-22.6), and negative predictive value of 100% (95%CI:87.4-100). PP fasting plasma glucose generated an AUC of 0.96 (95%CI:0.89-0.99) for the identification of PP glucose intolerance. Our study found that PP pGCD9 may be a promising biomarker to identify women not requiring PP glucose intolerance screening using the traditional OGTT. While the diagnostic accuracy of pGCD59 is good, fasting plasma glucose remains a better test for the identification of PP glucose intolerance.