Pregnancy‐associated plasma protein‐A2 levels are increased in early‐pregnancy gestational diabetes: a novel biomarker for early risk estimation

Abstract

Aim To determine whether pregnancy‐associated plasma protein‐A2 levels are increased in early pregnancies complicated by gestational diabetes and whether gestation age influences levels. The possible use of pregnancy‐associated plasma protein‐A2 as a pre‐screening biomarker to reduce the need for performing oral glucose tolerance tests in pregnant women was also investigated. Methods Pregnant women were diagnosed with gestational diabetes in early pregnancy after a 2‐hour 75 g oral glucose tolerance test in the catchment area of Skåne University Hospital, Lund, Sweden during 2011–2015 (n = 99). Age‐ and BMI‐matched pregnant women without diabetes were recruited at similar gestational ages from maternal healthcare centres in the same geographical area during 2014–2015 to act as controls (n = 100). Circulating pregnancy‐associated plasma protein‐A2 was analysed in participant serum using commercially available enzyme‐linked immunosorbent assay kits. Results Circulating pregnancy‐associated plasma protein‐A2 was increased in women diagnosed with gestational diabetes [13.5 (9.58–18.8) ng/ml] compared with controls [8.11 (5.74–11.3) ng/ml; P < 0.001]. Pregnancy‐associated plasma protein‐A2 was associated with gestational diabetes independent of age, BMI, C‐peptide and adiponectin (P < 0.001). Pregnancy‐associated plasma protein‐A2 as a pre‐screening biomarker to identify women at a decreased risk of gestational diabetes resulted in a negative predictive value of 99.7%, with a sensitivity of 96% and a specificity of 30% at a cut‐off level of 6 ng/ml. Conclusions This is the first study to show increased pregnancy‐associated plasma protein‐A2 levels in gestational diabetes. Pregnancy‐associated plasma protein‐A2 also shows promise as a pre‐screening biomarker with the potential to reduce the need for performing oral glucose tolerance tests in early pregnancy. Future prospective cohort studies in a larger group of both high‐ and low‐risk women are, however, needed to further confirm this observation.

Plasma cytokines during pregnancy provide insight into the risk of diabetes in the gestational diabetes risk group

“…However, we were not able to confirm this finding based on our cohort, which was biased toward GDM (associated with a macrosomic fetus). We detected lower levels of adiponectin in women with GDM, as reported in many other studies 18 , 19 , 20 . Adiponectin has been linked with insulin sensitization, and a decline in adiponectin levels might show adipose tissue dysfunction, which can precede GDM 20 .…”

“…We detected lower levels of adiponectin in women with GDM, as reported in many other studies 18 , 19 , 20 . Adiponectin has been linked with insulin sensitization, and a decline in adiponectin levels might show adipose tissue dysfunction, which can precede GDM 20 . Maternal hypoadiponectinemia could also be an important risk factor for type 2 diabetes development later in life 21 .…”

Effect of Evidence-Based Diet Nursing on Intestinal Flora and Maternal and Infant Prognosis in Patients with Gestational Diabetes

“…While Bifidobacterium can regulate intestinal dysfunction, Lactobacillus can maintain intestinal health and regulate immune function, Escherichia coli is parasitic in the large intestine, and invasion of the body can cause infection. e ratio of Bifidobacterium to Escherichia coli can reflect the colonization of intestinal flora to some extent [32][33][34]. is study found that the ratio of intestinal Bifidobacterium, Lactobacillus, and Bifidobacterium to Escherichia coli in the patients receiving evidence-based nursing combined with diet nursing intervention was higher than that in the patients receiving routine nursing combined with diet nursing intervention, suggesting that evidence-based nursing combined with diet nursing can improve the intestinal flora of patients with gestational diabetes, which indirectly proves that evidence-based nursing combined with diet nursing is more conducive to blood glucose control.…”

Baby New Year

“…Dereke et al. report that pregnancy‐associated plasma protein‐A2 concentrations are increased in gestational diabetes and measurement of this protein in early pregnancy shows promise as a pre‐screening biomarker with the potential to reduce the need for glucose tolerance tests.…”

“…Biomarkers are needed to help identify women at risk of gestational diabetes to improve the efficiency of screening and diagnosis while lengthening the opportunity for intervention. Dereke et al [4] report that pregnancy-associated plasma protein-A2 concentrations are increased in gestational diabetes and measurement of this protein in early pregnancy shows promise as a pre-screening biomarker with the potential to reduce the need for glucose tolerance tests.…”