title: Maternal serum osteocalcin at 11-14 weeks of gestation in gestational diabetes mellitus.
abstract: BACKGROUND
  Recent studies support that osteocalcin (OC), apart from its skeletal role, is implicated in glucose homoeostasis. Aims of this study were to examine the first-trimester maternal serum concentrations of OC in pregnancies that developed gestational diabetes mellitus (GDM) and to create a first-trimester prediction model for GDM.
  
  
  METHODS
  Case-control study in a prospective cohort of pregnant women. Maternal serum levels of OC were measured in 40 cases that developed GDM and 94 unaffected controls. First-trimester biophysical parameters, biochemical indices, maternal-pregnancy characteristics, and OC concentrations were assessed in relation to GDM occurrence.
  
  
  RESULTS
  In the GDM group, first-trimester OC serum levels were increased compared to the control group (mean = 8·81 ng/mL, SD = 2·59 vs. mean = 7·34 ng/ml, SD = 3·04, P = 0·0058). Osteocalcin was independent of first-trimester biophysical and biochemical indices. Osteocalcin alone (OR = 1·21, CI: 1·02-1·43, P = 0·023) was a significant predictor of GDM [Model R(2) = 0·04, area under the curve (AUC) = 0·61, CI: 0·55-0·72, P < 0·001]. The combination of maternal and pregnancy characteristics with OC resulted in an improved prediction model for GDM (Model R(2) = 0·21, AUC = 0·80, CI: 0·71-0·88, P < 0·001). The combined model yields a sensitivity of 72·2% for 25% false-positive rate.
  
  
  CONCLUSIONS
  First-trimester maternal serum levels of OC are increased in GDM pregnancies. Osteocalcin combined with maternal and pregnancy characteristics provides an effective screening for GDM at 11-14 weeks.
authors: Fetal Medicine Unit, Embryocare, Athens, Greece.|Fetal Medicine Unit, Emvryomitriki, Athens, Greece.
authors: Ioannis
authors: I
authors: Papastefanou
authors: Fetal Medicine Unit, Embryocare, Athens, Greece.|1st Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.|Department of Ultrasound and Fetal Medicine, Bioiatriki SA, Athens, Greece.
authors: Makarios
authors: M
authors: Eleftheriades
authors: 1st Department of Obstetrics and Gynecology, University of Athens Medical School, Alexandra Hospital, Athens, Greece.
authors: Dimitra
authors: D
authors: Kappou
authors: 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece.
authors: Irene
authors: I
authors: Lambrinoudaki
authors: Hormone Laboratory, Bioiatriki SA, Athens, Greece.
authors: Demetrios
authors: D
authors: Lavranos
authors: 1st Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.|Childhood Obesity Clinic, 1st Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.
authors: Panagiota
authors: P
authors: Pervanidou
authors: 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors: Alexandros
authors: A
authors: Sotiriadis
authors: 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece.
authors: Demetrios
authors: D
authors: Hassiakos
authors: 1st Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.
authors: George P
authors: GP
authors: Chrousos
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D006801:Humans; D008423:Maternal Age; D015675:Osteocalcin / Q000378:metabolism*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D015675:Osteocalcin
keywords: First-trimester assessment; gestational diabetes mellitus; osteocalcin; prediction model