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ADA: First Trimester Blood Test Predicts Gestational Diabetes with 92% Accuracy

A simple blood test could be incorporated into prenatal care, possibly as early as the first prenatal visit….

A blood test during the first trimester of pregnancy predicted gestational diabetes (GDM) with 92% accuracy, according to a new study.

GDM is associated with a greater risk for pregnancy complications and a higher risk of developing type 2 diabetes later in life.

The researchers tested a potential GDM assay that relies on serum glycoproteins, based on the hypothesis that hyperglycemia in GDM would increase hexosamine biosynthetic pathway flux, which in turn would alter the glycosylation of serum proteins.

In a prospective observational study of 150 Finnish women, the researches collected serum samples at gestational weeks 9 through 11, and again between weeks 16 and 27. They used a standard oral glucose tolerance test to diagnose GDM.

Analytes included fibronectin glycosylation associated with Sambucus nigra lectin binding (FN-SNA), adiponectin, sex hormone-binding globulin (SHBG), and C-reactive protein (CRP). Test results were analyzed with receiver operating characteristic curves from logistic regression modeling.

In the first trimester, the researchers found significant associations between subsequent development of GDM and levels of FN-SNA, adiponectin, and CRP. Among 50 patients with GDM, compared with 50 matched control patients, mean FN-SNA concentration was higher (102 ± 30 mg/L vs 56 ± 15 mg/L; P < .0001). FN-SNA had a false-positive rate of 4% and revealed 84% of first-trimester GDM cases. When adiponectin and CRP were added, the detection rate increased to 92%.

In the second trimester, there were statistically significant associations between GDM and FN-SNA, adiponectin, and SHBG (P < .01). The area under the curve for FN-SNA was 0.92 (95% confidence interval [CI], 0.86 - 0.98). When adiponectin and SHBG were added, this increased to 0.99 (95% CI, 0.98 - 1.00).

“Our data demonstrate that maternal serum FN-SNA represents a promising single-marker test for early identification of women at risk for GDM. Reliable early diagnosis using maternal serum glycoprotein biomarkers can facilitate new intervention strategies to prevent the complications of GDM,” the authors write in the abstract.

Charles T. Roberts, PhD, associate director for research and senior scientist in the Division of Neuroscience and the Division of Reproductive Sciences at the Oregon National Primate Research Center and professor of medicine, pediatrics, and cell and developmental biology at Oregon Health Sciences University, Portland, presented the study at a poster session at the American Diabetes Association (ADA) 72nd Scientific Sessions.

American Diabetes Association (ADA) 72nd Scientific Sessions: Abstract 840-P. Presented June 10, 2012.