<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>

Abstract

To evaluate the associations of serum uric acid (UA), urea nitrogen (UN), and urine specific gravity (USG) levels in the first trimester of pregnancy with the risk of gestational diabetes mellitus (GDM). Patients and Methods: A retrospective cohort study was conducted in 1,769 pregnant women aged 31.55 ± 3.91 years. UA, UN, and USG levels were measured during the 16-18th week of gestation. GDM was diagnosed by an oral 75 g glucose tolerance test during the 24-28th week of gestation. Results: A multivariate adjusted logistic regression analysis showed that UA levels in the highest quartile increased the risk of GDM by 55.7% (odds ratio [OR]: 1.557, 95% confidence interval [CI]: 1.055-2.298; p = 0.026) compared to those in the lowest quartile. USG levels in the second, third, and fourth quartiles increased the risk of GDM by 67.6% (95% CI: 1.090-2.421), 112.4% (95% CI: 1.446-3.119), and 94.5% (95% CI: 1.314-2.880), respectively, compared to those in the first quartile (p trend = 0.001). No significant association between UN levels and the GDM risk was observed. When the extreme composite biomarker score quartiles were compared, the adjusted OR (95% CI) for GDM was 1.909 (95% CI: 1.332-2.736). Age-stratified analyses revealed similar results in women aged ≤35 years only, but not in those aged >35 years. Conclusion: Higher levels of UA and USG and a higher composite kidney function biomarker score during the 16-18th week of gestation were positively and independently associated with an increased risk of GDM.

Uric Acid: Friend or Foe?

“…Rehman et al 24 reported in their study of 172 pregnant women in the first trimester of pregnancy where mean uric acid levels of GDM mothers were higher compared to the control group; 3.73mg/dL (221.9µmol/ L) vs. 3.19mg/dL (189.74µmol/L). Li et al 25, in their study of 1769 pregnant women, also reported that GDM group mothers had higher mean serum uric acid levels than non-GDM mothers (216.45µmol/L vs. 209.36µmol/ L). They concluded that higher uric acid levels and a higher composite kidney function biomarker score during the 16-18th week of gestation were positively and independently associated with an increased risk of GDM.…”

Maternal uric acid levels and risk of gestational diabetes mellitus: A systematic review and dose–response meta‐analysis of cohort studies including 105,380 participants

“…Furthermore, 19 studies were excluded after the full-text screening. Finally, 23 studies were eligible for inclusion in the present study [18][19][20][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] . Table 1 summarizes the characteristics of the included studies.…”

“…The maternal blood uric acid concentration during pregnancy was measured in 21 of 23 studies at or before the 20th week of gestation [18][19][20]25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] , and the remaining studies measured it after the 20th week of gestation 26,44 . The maternal blood uric acid concentration during pregnancy was measured using calorimetric assays 18,20,25,27,28,[30][31][32][33][36][37][38][39]41 or a spectrometric method 29 , whereas eight out of 23 included studies did not provide data regarding the method of maternal blood uric acid measurement 19,26,34,35,40,[42][43][44] . Among the 23 included studies, five studies collected blood samples after 8-12 h of fasting for the measurement of maternal uric acid…”

“…The maternal blood uric acid concentration during pregnancy was measured using calorimetric assays 18,20,25,27,28,[30][31][32][33][36][37][38][39]41 or a spectrometric method 29 , whereas eight out of 23 included studies did not provide data regarding the method of maternal blood uric acid measurement 19,26,34,35,40,[42][43][44] . Among the 23 included studies, five studies collected blood samples after 8-12 h of fasting for the measurement of maternal uric acid 19,27,33,34,39 ; the remaining studies did not report the method by which blood samples were collected 18,20,25,26,[28][29][30][31][32][35][36][37][38][40][41][42][43][44] . Among the studies included in this systematic review, 13 studies were carried out on participants who were primiparous or multiparous…”

Characterizing and Evaluating Diurnal Salivary Uric Acid Across Pregnancy Among Healthy Women

“…A large body of research has examined UA levels in blood during pregnancy as a potential indicator of increased risk of gestational diabetes, hypertension, preeclampsia, and other related adverse health outcomes. Serum UA levels, particularly in early pregnancy, have been associated with increased risk of developing GDM (8)(9)(10)(11). High concentrations of serum UA during pregnancy have also been associated with high BP and preeclampsia, as well as related poor birth outcomes such as lower birth weight and earlier gestational age at birth (12)(13)(14)(15)(16)(17)(18)(19).…”