title: Sex-hormone-binding globulin early in pregnancy for the prediction of severe gestational diabetes mellitus and related complications.
abstract: OBJECTIVE
  The aim of this study was to evaluate the predictive value of sex-hormone-binding globulin (SHBG) for the diagnosis of gestational diabetes mellitus (GDM), and to clarify the association between SHBG levels and GDM complications/medication requirements.
  
  
  METHODS
  Among the participants (n = 93) who provided blood samples between 13 and 16 weeks' gestation, 30 cases subsequently developed GDM. Complications and medical interventions were noted. The best cut-off point of SHBG and diagnostic performance were calculated.
  
  
  RESULTS
  The mean age was 28.45 ± 5.0 years. SHBG levels were lower in the GDM group (n = 30) when compared with non-GDM (n = 63) cases (<0.01). Among the GDM women, SHBG was lower in the insulin therapy group (n = 15) compared with medical nutritional therapy alone (n = 15) (P < 0.01). A good predictive accuracy of SHBG was found for GDM requiring insulin therapy (area under the curve: 0.866, 95% confidence interval: 0.773-0.959). An SHBG threshold for 97.47 nmol/L had a sensitivity of 80.0%, specificity 84.6%, positive predictive value 50.0% and negative predictive value 95.7%. The calculated odds ratio for SHBG < 97.47 nmol/L was 12.346 (95% confidence interval: 1.786-83.33).
  
  
  CONCLUSIONS
  SHBG is valuable for screening women early in pregnancy for GDM risk; however, a standard assay for analyses and a threshold level of serum SHBG for a constant gestational week has to be determined.
authors.affiliation: Departments of Obstetrics and Gynecology Biochemistry, Ufuk University, Ankara, Turkey. gamzesinem@hotmail.com
authors.forename: Gamze S
authors.initials: GS
authors.lastname: Caglar
authors.forename: Elif D U
authors.initials: ED
authors.lastname: Ozdemir
authors.forename: Sevim D
authors.initials: SD
authors.lastname: Cengiz
authors.forename: Selda
authors.initials: S
authors.lastname: Demirtaş
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016015:Logistic Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D012738:Sex Hormone-Binding Globulin