Temporal Variation in Soluble Human Leukocyte Antigen‐G (sHLA‐G) and Pregnancy‐Associated Plasma Protein A (PAPP‐A) in Pregnancies Complicated by Gestational Diabetes Mellitus and in Controls

Abstract

PAPP-A and sHLA-G are independent markers of GDM. Quantitative variations during pregnancy help to early unravel the onset of GDM.

Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

“…Lovati et al 8 showed that women with GDM had a significantly lower PAPP-A MoM if they received insulin therapy than women with GDM who were managed by diet (0.56 vs 0.76 MoM; P<0.001). Beneventi et al 29 showed a similar result that PAPP-A MoM was significantly lower in GDM managed with insulin treatment than GDM without (0.87 vs 1.11 MoM; P=0.031). These studies showed that insulin-dependent GDM Abbreviations: β-HCG = β-human chorionic gonadotrophin; GDM = gestational diabetes mellitus; MoM = multiple of median; NA = not available; OGTT = oral glucose tolerance test; PAPP-A = pregnancy-associated plasma protein-A * Data are expressed as median (25th-75th percentile) or mean ± standard deviation † P<0.05 Case control 228 228 NA 0.7 (0.5-1.2) † 1.2 (0.8-1.6) 0.9 (0.6-1.6) 1 (0.7-1. was more strongly correlated with lower PAPP-A MoM.…”

“…There were, however, only two (1.2%) women with GDM in our study who required insulin, a much lower frequency compared with other study populations (12%-100%). 8,9,11,18,23,[26][27][28][29] Although both women had a lower PAPP-A MoM than women with non-insulin-treated GDM or non-GDM group, such a small proportion is insufficient to determine whether PAPP-A MoM differs significantly between women with insulin-treated GDM and non-insulintreated women with GDM. The low frequency of insulin treatment in our study population may imply that the majority of affected Chinese women had mild GDM and may also explain why our study population did not exhibit changes in PAPP-A MoM during the first trimester.…”

“…This is consistent with the results of three other studies 18,26,27 but contradicts others. 8,9,11,23,28,29 These published series are summarised in Table 5. 8,9,11,18,23,[26][27][28][29] There are several possible explanations for the different results of these studies, including ours.…”

First-trimester biochemical markers of placentation in screening for gestational diabetes mellitus

“…Five previous studies reported that in GDM serum PAPP-A was reduced by 9-42% [8,10,[12][13][14], but in another three studies there were no significant differences between GDM and unaffected pregnancies [9,11,15]. Such differences may be the consequence of the small number of cases of GDM in most studies and possible differences in the methods of screening and diagnosis of GDM.…”

“…Some studies that examined first-trimester serum PAPP-A in women who subsequently developed GDM reported that the levels were reduced, but other studies reported that the levels were not significantly altered [8][9][10][11][12][13][14][15]. In contrast, two case-control studies that examined first-trimester serum PLGF reported that in women who developed GDM the levels were increased [15,16].…”