Evaluation of glucose intolerance in pregnancy using biochemical markers of fetal hyperinsulinemia.
We aimed to evaluate gestational impaired glucose tolerance (GIGT) in untreated patients using umbilical cord blood insulin and connecting peptide (C-peptide) concentrations to indicate fetal hyperinsulinemia. A 75 g, 2-hour oral glucose tolerance test, evaluated using WHO criteria, was performed in 722 antenatal patients. Cord C-peptide (p = 0.001) and insulin (p = 0.008) concentrations were significantly higher in patients with GIGT in comparison to those with normal glucose tolerance. The WHO test failed to identify abnormal C-peptide concentrations (p = 0.057), but did identify abnormal insulin concentrations (p = 0.006) and cases where either or both were raised (p = 0.002), with a low Youden's index (range 8.1-11.3) in all 3 cases. A significant biochemical difference exists in patients with GIGT. The WHO criteria for GIGT predict abnormal biochemical outcomes, but they do so poorly.
Roach
V J
VJ
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT. roach2082@cuhk.edu.hk
Fung
H
H
Cockram
C S
CS
Lau
T K
TK
Rogers
M S
MS
D015415:Biomarkers; D002096:C-Peptide / Q000097:blood; D016640:Diabetes, Gestational; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005315:Fetal Diseases / Q000097:blood*; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood*; D011247:Pregnancy; D011248:Pregnancy Complications
D015415:Biomarkers; D002096:C-Peptide