title: Prediction of gestational diabetes mellitus in the first trimester: comparison of C-reactive protein, fasting plasma glucose, insulin and insulin sensitivity indices.
abstract: OBJECTIVE
  To develop a predictive index based on high sensitivity C-reactive protein (hs-CRP), fasting plasma glucose (FPG) and fasting plasma insulin (FPI) measurements for early diagnosis of gestational diabetes mellitus (GDM).
  
  
  METHODS
  Healthy pregnant women who were screened for GDM during their first antenatal visit were included in this retrospective cohort study. FPG, FPI and serum hs-CRP concentrations were measured between weeks 11 and 14. A two-step glucose challenge test was carried out between gestational weeks 24 and 28. Fasting glucose/insulin ratio (FIGR), Homeostatic Model Assessment Insulin Resistance (HOMA-IR), HOMA-β indices and Quantitative Insulin Sensitivity Check Index (QUICKI) were used to estimate insulin sensitivity and β-cell function.
  
  
  RESULTS
  Of the 450 women who were eligible for the study, 49 (11.2%) were diagnosed with GDM at weeks 24-28. The median FPG and hs-CRP levels were higher in the GDM diagnosed women compared to the others. Comparison of accuracy measures resulted in the highest specificity (87.2%; 95% CI 83.5-90.1) and diagnostic odds ratio (3.9; 95% CI 2.1-7.6) for hs-CRP.
  
  
  CONCLUSIONS
  FPG and hs-CRP in the first trimester are correlated with later development of GDM in the pregnancy. In our study, FPG provided a better sensitivity while hs-CRP exhibited a better specificity for prediction of GDM.
authors.affiliation: a Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey.
authors.forename: A Seval
authors.initials: AS
authors.lastname: Ozgu-Erdinc
authors.affiliation: a Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey.
authors.forename: Saynur
authors.initials: S
authors.lastname: Yilmaz
authors.affiliation: a Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey.
authors.forename: M Ilkin
authors.initials: MI
authors.lastname: Yeral
authors.affiliation: a Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey.
authors.forename: K Doga
authors.initials: KD
authors.lastname: Seckin
authors.affiliation: a Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey.
authors.forename: Salim
authors.initials: S
authors.lastname: Erkaya
authors.affiliation: a Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey.
authors.forename: A Nuri
authors.initials: AN
authors.lastname: Danisman
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D003661:Decision Support Techniques; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D016015:Logistic Models; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D002097:C-Reactive Protein
keywords: Fasting plasma glucose; gestational diabetes mellitus; high sensitivity C-reactive protein; homeostatic model assessment; insulin