First‐trimester blood urea nitrogen and risk of gestational diabetes mellitus

Abstract

Prior studies indicated that urea increased insulin resistance and higher blood urea nitrogen (BUN) was associated with incident diabetes mellitus. However, it remains unclear whether BUN during the first trimester of pregnancy increases risk of gestational diabetes mellitus (GDM). We aimed to investigate the association between first‐trimester BUN and risk of incident GDM. We conducted a prospective, multicenter cohort study of pregnant women. A total of 13 448 eligible pregnant women with measured first‐trimester BUN levels were included in this analysis. Logistic regression analysis was used to estimate the relationship between BUN and GDM. Discrimination and reclassification for GDM by BUN were analysed. A total of 2973 (22.1%) women developed GDM. Compared with the lowest quartile of BUN, the third and fourth quartiles were associated with increased risk of GDM (adjusted odds ratios 1.21 [95% CI 1.07‐1.37] and 1.50 [95% CI 1.33‐1.69], respectively, P for trend <.001). The addition of BUN to conventional factor model improved discrimination (C statistic 0.2%, P = .003) and reclassification (net reclassification index 14.67%, P < .001; integrated discrimination improvement 0.12%, P < .001) for GDM. In conclusion, higher BUN concentrations during the first trimester of pregnancy were associated with increased risk of GDM, suggesting that BUN could be a potential predictor for GDM.

<p>Association of Serum Uric Acid, Urea Nitrogen, and Urine Specific Gravity Levels at 16–18 Weeks of Gestation with the Risk of Gestational Diabetes Mellitus</p>

“…The main difference between the study by Feng et al 22 and the present study is the age of the participants (27.63 ± 4.09 vs 31.55 ± 3.91 years, respectively), which may provide a potential explanation for the discrepancy between the studies, particularly due to our finding that…”

“…38 A study in China by Feng et al that included 13,448 eligible pregnant women, of which 2,793 had GDM, reported that elevated UN levels in early pregnancy were positively and dose-responsively correlated with an increased risk of GDM. 22 However, we detected no association between UN and GDM in either our total population or age-stratified subgroups.…”

“… 38 A study in China by Feng et al that included 13,448 eligible pregnant women, of which 2,793 had GDM, reported that elevated UN levels in early pregnancy were positively and dose-responsively correlated with an increased risk of GDM. 22 However, we detected no association between UN and GDM in either our total population or age-stratified subgroups. The main difference between the study by Feng et al 22 and the present study is the age of the participants (27.63 ± 4.09 vs 31.55 ± 3.91 years, respectively), which may provide a potential explanation for the discrepancy between the studies, particularly due to our finding that increased maternal age may have an impact on the likelihood of developing GDM in response to altered kidney function.…”

“… 21 To date, only one study has explored whether UN levels in the first trimester are related to the risk of developing GDM, and identified UN as a potential predictor of GDM. 22 However, whether UN is associated with GDM remains to be fully determined.…”

Circulating FABP4, nesfatin-1, and osteocalcin concentrations in women with gestational diabetes mellitus: a meta-analysis

“…Diagnosis of GDM generally occurs at an advanced gestational age, thus limiting preventive strategies. Therefore, there is a growing interest in the initial prediction of GDM [3].…”