Pregnancy-associated plasma protein-A2 levels are increased in early-pregnancy gestational diabetes : a novel biomarker for early risk estimation
(2020) In Diabetic Medicine 37(1). p.131-137- Abstract
Aim: To determine whether pregnancy-associated plasma protein-A2 levels are increased in early pregnancies complicated by gestational diabetes and whether gestation age influences levels. The possible use of pregnancy-associated plasma protein-A2 as a pre-screening biomarker to reduce the need for performing oral glucose tolerance tests in pregnant women was also investigated. Methods: Pregnant women were diagnosed with gestational diabetes in early pregnancy after a 2-hour 75 g oral glucose tolerance test in the catchment area of Skåne University Hospital, Lund, Sweden during 2011–2015 (n = 99). Age- and BMI-matched pregnant women without diabetes were recruited at similar gestational ages from maternal healthcare centres in the same... (More)
Aim: To determine whether pregnancy-associated plasma protein-A2 levels are increased in early pregnancies complicated by gestational diabetes and whether gestation age influences levels. The possible use of pregnancy-associated plasma protein-A2 as a pre-screening biomarker to reduce the need for performing oral glucose tolerance tests in pregnant women was also investigated. Methods: Pregnant women were diagnosed with gestational diabetes in early pregnancy after a 2-hour 75 g oral glucose tolerance test in the catchment area of Skåne University Hospital, Lund, Sweden during 2011–2015 (n = 99). Age- and BMI-matched pregnant women without diabetes were recruited at similar gestational ages from maternal healthcare centres in the same geographical area during 2014–2015 to act as controls (n = 100). Circulating pregnancy-associated plasma protein-A2 was analysed in participant serum using commercially available enzyme-linked immunosorbent assay kits. Results: Circulating pregnancy-associated plasma protein-A2 was increased in women diagnosed with gestational diabetes [13.5 (9.58–18.8) ng/ml] compared with controls [8.11 (5.74–11.3) ng/ml; P < 0.001]. Pregnancy-associated plasma protein-A2 was associated with gestational diabetes independent of age, BMI, C-peptide and adiponectin (P < 0.001). Pregnancy-associated plasma protein-A2 as a pre-screening biomarker to identify women at a decreased risk of gestational diabetes resulted in a negative predictive value of 99.7%, with a sensitivity of 96% and a specificity of 30% at a cut-off level of 6 ng/ml. Conclusions: This is the first study to show increased pregnancy-associated plasma protein-A2 levels in gestational diabetes. Pregnancy-associated plasma protein-A2 also shows promise as a pre-screening biomarker with the potential to reduce the need for performing oral glucose tolerance tests in early pregnancy. Future prospective cohort studies in a larger group of both high- and low-risk women are, however, needed to further confirm this observation.
(Less)
- author
- Dereke, J. LU ; Nilsson, C. LU ; Strevens, H. LU ; Landin-Olsson, M. LU and Hillman, M. LU
- organization
- publishing date
- 2020-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Diabetic Medicine
- volume
- 37
- issue
- 1
- pages
- 7 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:31340069
- scopus:85071160660
- ISSN
- 0742-3071
- DOI
- 10.1111/dme.14088
- language
- English
- LU publication?
- yes
- id
- 1e8b8cc9-b14d-426a-bd05-b27e89b53a42
- date added to LUP
- 2019-09-03 11:33:40
- date last changed
- 2024-02-15 19:32:17
@article{1e8b8cc9-b14d-426a-bd05-b27e89b53a42, abstract = {{<p>Aim: To determine whether pregnancy-associated plasma protein-A2 levels are increased in early pregnancies complicated by gestational diabetes and whether gestation age influences levels. The possible use of pregnancy-associated plasma protein-A2 as a pre-screening biomarker to reduce the need for performing oral glucose tolerance tests in pregnant women was also investigated. Methods: Pregnant women were diagnosed with gestational diabetes in early pregnancy after a 2-hour 75 g oral glucose tolerance test in the catchment area of Skåne University Hospital, Lund, Sweden during 2011–2015 (n = 99). Age- and BMI-matched pregnant women without diabetes were recruited at similar gestational ages from maternal healthcare centres in the same geographical area during 2014–2015 to act as controls (n = 100). Circulating pregnancy-associated plasma protein-A2 was analysed in participant serum using commercially available enzyme-linked immunosorbent assay kits. Results: Circulating pregnancy-associated plasma protein-A2 was increased in women diagnosed with gestational diabetes [13.5 (9.58–18.8) ng/ml] compared with controls [8.11 (5.74–11.3) ng/ml; P < 0.001]. Pregnancy-associated plasma protein-A2 was associated with gestational diabetes independent of age, BMI, C-peptide and adiponectin (P < 0.001). Pregnancy-associated plasma protein-A2 as a pre-screening biomarker to identify women at a decreased risk of gestational diabetes resulted in a negative predictive value of 99.7%, with a sensitivity of 96% and a specificity of 30% at a cut-off level of 6 ng/ml. Conclusions: This is the first study to show increased pregnancy-associated plasma protein-A2 levels in gestational diabetes. Pregnancy-associated plasma protein-A2 also shows promise as a pre-screening biomarker with the potential to reduce the need for performing oral glucose tolerance tests in early pregnancy. Future prospective cohort studies in a larger group of both high- and low-risk women are, however, needed to further confirm this observation.</p>}}, author = {{Dereke, J. and Nilsson, C. and Strevens, H. and Landin-Olsson, M. and Hillman, M.}}, issn = {{0742-3071}}, language = {{eng}}, number = {{1}}, pages = {{131--137}}, publisher = {{Wiley-Blackwell}}, series = {{Diabetic Medicine}}, title = {{Pregnancy-associated plasma protein-A2 levels are increased in early-pregnancy gestational diabetes : a novel biomarker for early risk estimation}}, url = {{http://dx.doi.org/10.1111/dme.14088}}, doi = {{10.1111/dme.14088}}, volume = {{37}}, year = {{2020}}, }