title: Evaluation of glucose intolerance in pregnancy using biochemical markers of fetal hyperinsulinemia.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT. roach2082@cuhk.edu.hk
authors.forename: V J
authors.initials: VJ
authors.lastname: Roach
authors.forename: H
authors.initials: H
authors.lastname: Fung
authors.forename: C S
authors.initials: CS
authors.lastname: Cockram
authors.forename: T K
authors.initials: TK
authors.lastname: Lau
authors.forename: M S
authors.initials: MS
authors.lastname: Rogers
mesh_terms: 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
chemical_list: D015415:Biomarkers; D002096:C-Peptide