Predictive Value of First Trimester Measurement of Adiponectin and 1,5 Anhydroglucitol in Diagnosis of Gestational Diabetes Mellitus
Merhan M. Salem *
Obstetrics & Gynecology Department, Faculty of Medicine, Tanta University is an Egyptian, Tanta, Egypt.
Amal A. El-Sokary
Obstetrics & Gynecology Department, Faculty of Medicine, Tanta University is an Egyptian, Tanta, Egypt.
Sahar M. Hazzaa
Clinical Pathology Department, Faculty of Medicine, Tanta University Tanta University is an Egyptian, Tanta, Egypt.
Mohamed N. El-Gharib
Obstetrics & Gynecology Department, Faculty of Medicine, Tanta University is an Egyptian, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Gestational diabetes mellitus (GDM) defined as glucose intolerance, which is first detected during pregnancy. Adiponectin is a protein that secreted from both adipose tissue & placenta in pregnancy. 1,5 anhydroglucitol in a steady-state normally and almost completely reabsorbed in renal tubules. Serum levels decreased in periods of hyperglycemia due to increased urinary excretion. The objective of this study is to predict gestational diabetes by measuring serum adiponectin, and 1, 5 anhydroglucitol during the first trimester.
Materials and Methods: This case-control study was conducted on 50 patients who attended inpatient and outpatient clinics Obstetrics & Gynecology Department. The study population grouped in two groups, Group A and B. Each group was comprised of 25 cases. Group I (25 cases): with high risk for gestational diabetes. Group II (25 cases): with no risk locates for developing gestational diabetes. Serum glucose level and adiponectin 1,5 anhydroglucitol was measured by ELISA method in the first trimester.
Results: The mean levels of the Adiponectin (μg/ml) and the 1,5 AG were significantly lower in GDM women (5.2 ± 2.1μg/mL,) and (6.8 ± 5.7μg/mL,) respectively compared to women without GDM (7.8 ± 2.4μg/mL) and (9.8 ± 4.2μg/mL) respectively (p = 0.001). The correlation between Adiponectin and BMI >30KG/M2, Fasting plasma glucose in the study group I with a significant correlation between in the first trimester. ROC curve of 1,5 AG was conducted for developing gestational diabetes. Excellent AUC was found (AUC = 0.907, p<0.001). At the cut off value of 17.55, sensitivity was 100%, specificity was 80%, PPV was 88.3%, NPV was 87%, and accuracy was 90%. ROC curve of Adiponectin for developing gestational. Good AUC was found (AUC = 0.881, p<0.001). At the cut off value of 17.3, sensitivity was 100%, specificity was 66.7%, PPV was 83.2%, NPV was 80%, and accuracy was 94%.
Conclusion: 1,5 AG and Adiponectin levels are lower in pregnant women with GDM compared to individuals without GDM. 1,5 AG and adiponectin are a good tool for monitoring the glucose profile in pregnancies complicated by diabetes mellitus, especially for the hyperglycemic episodes.
Keywords: Adiponectin, 1,5 anhydroglucitol, first trimester, gestational diabetes.