title: Role of first trimester total testosterone in prediction of subsequent gestational diabetes mellitus.
abstract: OBJECTIVE
  To assess the role of first trimester maternal testosterone and dehydroepiandrosterone sulfate (DHEA-S) levels in prediction of development of gestational diabetes mellitus (GDM).
  
  
  METHODS
  Four hundred and fifty pregnant women were included in this prospective cohort study. All pregnant women with a singleton pregnancy who were not diabetic, had no family history of diabetes, had no history of previous GDM, were of white race and non-smokers were enrolled. Total testosterone and DHEA-S were measured at 11-14 weeks of gestation. The patients were called for routine pregnancy visits and followed accordingly. Forty-two patients did not come to their visits and were excluded. During gestational weeks 24-28, the remaining 408 patients were screened for GDM. The total testosterone and DHEA-S levels were compared between patients with and without GDM. Regression and receiver-operator curve analysis were performed.
  
  
  RESULTS
  GDM developed in 22 women (5.7%). Compared with women without GDM, first trimester total testosterone levels were higher among women in whom GDM subsequently developed. The DHEA-S level did not differ. Age, total testosterone and body mass index were found to be independent predictors of GDM development. A total testosterone value of 0.45 ng/mL was found to predict development of GDM with a sensitivity of 63.6% and a specificity of 62.7%.
  
  
  CONCLUSIONS
  First trimester total testosterone has a low testing power for GDM screening with low sensitivity and specificity values and cannot be used as a marker alone. It may have a role in combination with other markers.
authors.affiliation: Department of Endocrinology, Ministry of Health Mersin Government Hospital, Mersin, Turkey.
authors.forename: Yavuz M
authors.initials: YM
authors.lastname: Gözükara
authors.forename: Hakan
authors.initials: H
authors.lastname: Aytan
authors.forename: Devrim
authors.initials: D
authors.lastname: Ertunc
authors.forename: Ekrem C
authors.initials: EC
authors.lastname: Tok
authors.forename: Fazli
authors.initials: F
authors.lastname: Demirtürk
authors.forename: Şemsettin
authors.initials: Ş
authors.lastname: Şahin
authors.forename: Pelin
authors.initials: P
authors.lastname: Aytan
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D013739:Testosterone / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate
keywords: dehydroepiandrosterone sulfate; first trimester; gestational diabetes mellitus; screening; testosterone