title: Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Universal screening for gestational diabetes mellitus (GDM) has not been implemented, and this has had substantial clinical implications. Biomarker-directed targeted screening might be feasible. We sought to determine the accuracy of circulating adiponectin for early prediction of GDM.
  
  
  METHODS
  A systematic review and meta-analysis of the literature to May 2015 identified studies in which circulating adiponectin was measured prior to a diagnosis of GDM. Data on diagnostic accuracy were synthesised by bivariate mixed effects and hierarchical summary receiver operating characteristic (HSROC) models.
  
  
  RESULTS
  Thirteen studies met the eligibility criteria, 11 of which (2,865 women; 794 diagnosed with GDM) had extractable data. Circulating adiponectin had a pooled diagnostic odds ratio (DOR) of 6.4 (95% CI 4.1, 9.9), a summary sensitivity of 64.7% (95% CI 51.0%, 76.4%) and a specificity of 77.8% (95% CI 66.4%, 86.1%) for predicting future GDM. The AUC of the HSROC was 0.78 (95% CI 0.74, 0.81). First trimester adiponectin had a pooled sensitivity of 60.3% (95% CI 46.0%, 73.1%), a specificity of 81.3% (95% CI 71.6%, 88.3%) and a DOR of 6.6 (95% CI 3.6, 12.1). The AUC was 0.79 (95% CI 0.75, 0.82). Pooled estimates were similar after adjustment for age, BMI or specific GDM diagnostic threshold.
  
  
  CONCLUSIONS
  Pre-pregnancy and early pregnancy measurement of circulating adiponectin may improve the detection of women at high risk of developing GDM. Prospective evaluation of the combination of adiponectin and maternal characteristics for early identification of those who do and do not require OGTT is warranted.
authors.affiliation: School of Medicine, Glasgow Royal Infirmary, University of Glasgow, Level 2, New Lister Building, Glasgow, G31 2ER, UK. stamatina.iliodromiti@glasgow.ac.uk.
authors.forename: Stamatina
authors.initials: S
authors.lastname: Iliodromiti
authors.affiliation: School of Medicine, Glasgow Royal Infirmary, University of Glasgow, Level 2, New Lister Building, Glasgow, G31 2ER, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sassarini
authors.affiliation: Jack Cole Building, University of St Andrews, St Andrews, UK.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Kelsey
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Lindsay
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: School of Medicine, Glasgow Royal Infirmary, University of Glasgow, Level 2, New Lister Building, Glasgow, G31 2ER, UK.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Nelson
mesh_terms: D052242:Adiponectin / Q000097:blood*; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011247:Pregnancy
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin
keywords: Adiponectin; Gestational diabetes; Meta-analysis; Prediction; Systematic review