title: Prediction of gestational diabetes mellitus at first trimester in low-risk pregnancies.
abstract: OBJECTIVE
  We aimed to assess the relationship among the sex hormone-binding globulin (SHBG), homeostasis model assessment (HOMA), glycosylated hemoglobin (HbA1c), and cholesterol panel values to predict subsequent gestational diabetes mellitus (GDM) in low-risk pregnancies.
  
  
  METHODS
  Thirty-eight pregnant women with GDM and 295 low-risk pregnant women without GDM were included in this study. Maternal blood samples were obtained during the first trimester examination to determine the SHBG, HbA1c, fasting blood glucose, insulin, thyroid stimulating hormone (TSH), free thyroxine, total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C) levels. The variables that exhibited statistically significant differences between the groups and independent predictors for GDM were examined using logistic regression analysis. The risk of developing GDM, according to cutoff values, was determined using receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  The SHBG, HOMA, LDL, and TG levels were found to be the significant independent markers for GDM [adjusted odds ratio (OR) = 0.991; 95% confidence interval (CI), 0.986-995; OR = 1.56; 95% CI, 1.24-1.98; OR = 1.02; 95% CI, 1.01-1.04; and OR = 1.01; 95% CI, 1.00-1.02, respectively]. The HbA1c, body mass index, and mean arterial pressure values were nonindependent predictors of GDM. The areas under the ROC curve used to determine the predictive accuracy of SHBG, HOMA, TG, and LDL-C for development of GDM were 0.73, 0.75, 0.70, and 0.72, respectively. For a false positive rate of 5% for the prediction of GDM, the values of the sensitivities were 21.1, 26.3, 21.1, and 18.4%, respectively.
  
  
  CONCLUSIONS
  The HOMA, SHBG, TG, and LDL-C levels are independent predictors for subsequent development of GDM in low-risk pregnancies, but they exhibit low sensitivity.
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Kumru
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey. Electronic address: drresular@hotmail.com.
authors.forename: Resul
authors.initials: R
authors.lastname: Arisoy
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Erdogdu
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
authors.forename: Oya
authors.initials: O
authors.lastname: Demirci
authors.affiliation: Department of Gynecology and Obstetrics, Liv Hospital, Istanbul, Turkey.
authors.forename: Mustecep
authors.initials: M
authors.lastname: Kavrut
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Ardıc
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
authors.forename: Nihan
authors.initials: N
authors.lastname: Aslaner
authors.affiliation: Deparment of Biochemistry, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aysen
authors.initials: A
authors.lastname: Ozkoral
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aktug
authors.initials: A
authors.lastname: Ertekin
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood*; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D012306:Risk; D012680:Sensitivity and Specificity; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002784:Cholesterol; D006442:Glycated Hemoglobin; D012738:Sex Hormone-Binding Globulin; D014280:Triglycerides
keywords: gestational diabetes mellitus; low-risk pregnancy; prediction; screening