title: Gestational diabetes mellitus and first trimester pregnancy-associated plasma protein A: A case-control study in a Chinese population.
abstract: OBJECTIVE
  To investigate the relationship between pregnancy-associated plasma protein A (PAPP-A) and gestational diabetes mellitus (GDM), and to determine whether PAPP-A has improved value for predicting GDM in a Chinese population.
  
  
  METHODS
  Clinical data for 599 GDM patients and 986 unaffected pregnant women undergoing both antenatal examinations and delivery were retrospectively analyzed. First-trimester serum PAPP-A levels were compared between the groups. Binary logistic regression analysis was used to explore the risk factors for GDM, and the area under the receiver operating characteristic curve was used to determine the value of PAPP-A for predicting GDM.
  
  
  RESULTS
  GDM-affected and unaffected pregnant women were significantly different in terms of age (P < 0.001), BMI (P < 0.001), family history of diabetes (P = 0.002), α-thalassemia trait (P < 0.01), parity (P < 0.001), conception methods (P < 0.001), gestational weeks at the time of labor (P < 0.001) and corrected PAPP-A multiples of the median values (P < 0.001). Binary logistic regression analysis showed that PAPP-A levels were negatively related to the subsequent development of GDM (odds ratio 0.798, 95% confidence interval 0.647-0.984). The area under the receiver operating characteristic curve for maternal factors was 0.684 (95% CI: 0.657-0.711), and did not significantly differ from that for the combination of maternal factors and serum PAPP-A levels, which was 0.686 (95% CI: 0.660-0.713; χ2= 0.625, P = 0.429).
  
  
  CONCLUSIONS
  Serum PAPP-A was an independent factor for the development of GDM in pregnant Chinese women. Serum-PAPP-A does not have improved value with respect to predicting GDM when combined with other maternal factors.
authors.affiliation: Department of Obstetrics and Gynecology, Maternal and Child Healthcare Hospital of Shenzhen City, Southern Medical University, Shenzhen, Guangdong, China.
authors.forename: Di
authors.identifier: http://orcid.org/0000-0002-0982-647X
authors.initials: D
authors.lastname: Xiao
authors.affiliation: Department of Obstetrics and Gynecology, Maternal and Child Healthcare Hospital of Shenzhen City, Southern Medical University, Shenzhen, Guangdong, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Chenhong
authors.affiliation: Department of Obstetrics and Gynecology, Maternal and Child Healthcare Hospital of Shenzhen City, Southern Medical University, Shenzhen, Guangdong, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Yanbin
authors.affiliation: Department of Obstetrics and Gynecology, Maternal and Child Healthcare Hospital of Shenzhen City, Southern Medical University, Shenzhen, Guangdong, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Lu
mesh_terms: D000328:Adult; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002681:China; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis* / Q000201:enzymology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D011266:Pregnancy-Associated Plasma Protein-A; C579283:PAPPA protein, human
keywords: Gestational diabetes mellitus; Predictive value; Pregnancy-associated plasma protein A