First trimester screening for gestational diabetes mellitus by maternal factors and markers of inflammation

Syngelaki, Argyro; Visser, Gerard H.A.; Krithinakis, Konstantinos; Wright, Alan; Nicolaides, Kypros H.

doi:10.1016/j.metabol.2015.10.029

Cited by 47 publications

(31 citation statements)

References 50 publications

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“…non-white ethnicity: including Asian, black Caribbean or Middle Eastern); history of having GDM or a macrosomic infant; maternal obesity[12] and occasionally biochemical markers. [13,14]…”

Section: Introductionmentioning

confidence: 99%

Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts

et al. 2017

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BackgroundEasily identifiable risk factors including: obesity and ethnicity at high risk of diabetes are commonly used to indicate which women should be offered the oral glucose tolerance test (OGTT) to diagnose gestational diabetes (GDM). Evidence regarding these risk factors is limited however. We conducted a systematic review (SR) and meta-analysis and individual participant data (IPD) analysis to evaluate the performance of risk factors in identifying women with GDM.MethodsWe searched MEDLINE, Medline in Process, Embase, Maternity and Infant Care and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2016 and conducted additional reference checking. We included observational, cohort, case-control and cross-sectional studies reporting the performance characteristics of risk factors used to identify women at high risk of GDM. We had access to IPD from the Born in Bradford and Atlantic Diabetes in Pregnancy cohorts, all pregnant women in the two cohorts with data on risk factors and OGTT results were included.ResultsTwenty nine published studies with 211,698 women for the SR and a further 14,103 women from two birth cohorts (Born in Bradford and the Atlantic Diabetes in Pregnancy study) for the IPD analysis were included. Six studies assessed the screening performance of guidelines; six examined combinations of risk factors; eight evaluated the number of risk factors and nine examined prediction models or scores. Meta-analysis using data from published studies suggests that irrespective of the method used, risk factors do not identify women with GDM well.Using IPD and combining risk factors to produce the highest sensitivities, results in low specificities (and so higher false positives). Strategies that use the risk factors of age (>25 or >30) and BMI (>25 or 30) perform as well as other strategies with additional risk factors included.ConclusionsRisk factor screening methods are poor predictors of which pregnant women will be diagnosed with GDM. A simple approach of offering an OGTT to women 25 years or older and/or with a BMI of 25kg/m2 or more is as good as more complex risk prediction models. Research to identify more accurate (bio)markers is needed.Systematic Review Registration: PROSPERO CRD42013004608

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“…non-white ethnicity: including Asian, black Caribbean or Middle Eastern); history of having GDM or a macrosomic infant; maternal obesity[12] and occasionally biochemical markers. [13,14]…”

Section: Introductionmentioning

confidence: 99%

Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts

et al. 2017

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“…Recent studies suggest that pro-inflammatory cytokines also play an important role in GDM pathogenesis [10]. The inflammatory response and an imbalance between pro-inflammatory and anti-inflammatory cytokines may lead to the development of pregnancy-induced glucose intolerance and insulin resistance [11]. Previous studies www.…”

Section: Introductionmentioning

confidence: 99%

IL16 and IL18 gene polymorphisms in women with gestational diabetes

Tarnowski

Wieczorek²,

Dziedziejko

et al. 2017

Ginekol Pol

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Objectives: Gestational diabetes mellitus is a carbohydrate intolerance that occurs during pregnancy. Various inflammatory mediators are considered to be risk factors leading to GDM development. Among them are pro-inflammatory cytokines, such as IL16 and IL18. The aim of this study was to examine the association between IL16 and IL18 polymorphisms and GDM. Material and methods:This study included 204 pregnant women with GDM and 207 pregnant women with normal glucose tolerance (NGT). All samples were genotyped in duplicate using allelic discrimination assays with TaqMan® probes.Results: We observed that there was a decreased frequency of IL16 rs4778889 CC genotype carriers among women with GDM (CC vs. CT + TT: OR = 0.14; 95% CI = 0.02-1.15; p = 0.034). However, there was no significant difference in the distribution of alleles (C vs. T: OR = 0.81; 95% CI = 0.54-1.21; p = 0.30). There was a decreased frequency of the IL18 rs187238 G allele among GDM women (G vs. C: OR = 0.71; 95% CI = 0.53-0.96; p = 0.027). We also observed a decreased frequency of the IL18 rs1946518 T allele among women with GDM; however, this difference had only borderline statistical significance. We observed an association between IL18 rs187238, rs1946518 and BMI in pregnant women. Conclusions:The results of this study suggest that IL18 rs187238 and rs1946518 polymorphisms may be associated with an increased risk of GDM as well as with BMI in pregnant women.

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“…In a study by Syngelaki et al was reported in pregnancies that develop GDM there is no evidence of an inflammatory response at 11-13 weeks' gestation and the levels of serum TNF-á and Hs-CRP are not useful in first-trimester screening for GDM [15]. In the other study by Corcoran et al however, higher levels of CRP were found to be significantly associated with macrosomia but hS-CRP did not demonstrate additional predictive ability for GDM [37].…”

Section: Discussionmentioning

confidence: 92%

“…There is evidence that inflammation as a central feature in the development of Type 2 diabetes mellitus is associated with insulin resistance. Inflammation has been reported in GDM but the prognostic significance of this remains to be fully elucidated 15,16 . Molecular basis of the relationship between infection and diabetes is associated with reaction of cytokines such as interleukin 6 and tumor necrosis factor (TNF).…”

mentioning

confidence: 99%

Diagnostic Value of C-reactive Protein in Determining of Gestational Diabetes Mellitus (GDM)

Ahi¹,

Kariman2*²,

Asl³

et al. 2016

Biosci., Biotech. Res. Asia

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This study was designed to evaluate diagnostic value of C-reactive protein in determining of gestational diabetes mellitus. The present case-control study was conducted on 60 pregnant women with GDM (case group) and 120 women with normal pregnancy (control group) referred to Ayatollah Taleghani and mahdiyeh Hospitals. The serum level of qualitative and quantitative CRP was measured and diagnostic value of CRP was determined. In this study information form was completed by interview and sampling was performed by convenience method. Data were analyzed by SPSS-17 and significance level of p<0.05 was considered. Serum CRP value in GDM and control groups was 3/ 59±3/2 and 1/44±3/3 mg/liter, respectively. Regarding to cut-off of 2/2 mg/liter, sensitivity, specificity, positive predictive value and negative predictive value of quantitative CRP were 71%, 60%, 47% and 81%, respectively in diagnosis of GDM. The under curve area was 0/70. Sensitivity, specificity, positive predictive value and negative predictive value of qualitative CRP in diagnosis of GDM was calculated 33/3%, 98/3%, 90% and 74%, respectively. It seems that measuring CRP in pregnant women with GDM risk factors can be used as a simple, new and reliable method to screen gestational diabetes mellitus.

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First trimester screening for gestational diabetes mellitus by maternal factors and markers of inflammation

Cited by 47 publications

References 50 publications

Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts

Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts

IL16 and IL18 gene polymorphisms in women with gestational diabetes

Diagnostic Value of C-reactive Protein in Determining of Gestational Diabetes Mellitus (GDM)

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