C-reactive protein as a screening test for gestational diabetes mellitus in first-trimester of pregnancy: a prospective cohort study

Abstract

Background: The current study aims to determine if increased inflammation identified by increased C-reactive protein (CRP) level is associated with the subsequent development of gestational diabetes mellitus (GDM).Methods: A prospective cohort study conducted at a tertiary University Hospital included 496 booking for their antenatal care visit between 10-12 weeks of gestation. They were tested for presence of CRP in blood. All women without a history of antenatal type 1 or type 2 diabetes undergo routine GDM screening with the 50-g oral glucose-loading test (GLT) between 24 and 28 weeks 'gestation. Women whose 1-h post-loading plasma glucose level >7.8 mmol/l (>140 mg/dl) undergo a diagnostic, fasting, 100-g, 3-h oral glucose tolerance test (OGTT) within 1-2 weeks following the GLT.Results: Among these 496 women, a total of 27 women (5.4%) were diagnosed as GDM and 10 women (2.0%) were diagnosed as IGT at week 24-28. The CRP was positive and higher in the GDM diagnosed group (p=0.000) compared to those who did not develop GDM. CRP was positively correlated with diagnosis of GDM (r=0.438, p=0.012).Conclusions: There is an association between first-trimester inflammation, marked by increased CRP levels and subsequent risk of GDM.

Elevated C-Reactive Protein (CRP) during First-Trimester For Gestational Diabetes Screening

“…In a current study out of ninety-three patients with raised CRP, 8(8.6%) developed GDM (p<0.00001) showing that high C-reactive protein can result in GDM. This is inconsistency with previous research studies 13,14 . Increased levels of CRP in the blood can lead to hyperglycaemia by influencing insulin resistance 15 .…”

“…A research study by Cunningham et al showed that the sensitivity and specificity of GCT in GDM screening varies with glucose thresholds such as 80% and 82-86% with 140mg/dl while 90% and 75-80%when kept at 130mg/dl 20 . Whereas Farghaly et al reported that CRP has a sensitivity and specificity of 86.49% and 98.47% respectively in detecting GDM 13 . The current study showed 100% sensitivity and 48.17% specificity of CRP in detecting GDM thus making it a good screening test for GDM owing to the very high sensitivity and simplicity of the test.…”

Update on the genetic and epigenetic etiology of gestational diabetes mellitus: a review

“…Relatively recently, serum levels of C-reactive protein (CRP) as well as glycated hemoglobin (HbA1c) and random blood sugar (RBS) are used as screening tools for GDM in the first trimester. CRP concentrations of about 6 mg/L or higher in undiluted serum samples are considered positive for GDM [149]. According to the International Association of the Diabetes and Pregnancy Study Group (IADPSG), the cutoff level of HbA1c is 6.5 % and RBS is 11.1 mmol (200mg/dL) [150].…”