Article

Sex-hormone-binding globulin early in pregnancy for the prediction of severe gestational diabetes mellitus and related complications.

Departments of Obstetrics and Gynecology Biochemistry, Ufuk University, Ankara, Turkey.
Journal of Obstetrics and Gynaecology Research (Impact Factor: 0.84). 05/2012; DOI: 10.1111/j.1447-0756.2012.01870.x
Source: PubMed

ABSTRACT Aims:  The aim of this study was to evaluate the predictive value of sex-hormone-binding globulin (SHBG) for the diagnosis of gestational diabetes mellitus (GDM), and to clarify the association between SHBG levels and GDM complications/medication requirements. Material and Methods:  Among the participants (n = 93) who provided blood samples between 13 and 16 weeks' gestation, 30 cases subsequently developed GDM. Complications and medical interventions were noted. The best cut-off point of SHBG and diagnostic performance were calculated. Results:  The mean age was 28.45 ± 5.0 years. SHBG levels were lower in the GDM group (n = 30) when compared with non-GDM (n = 63) cases (<0.01). Among the GDM women, SHBG was lower in the insulin therapy group (n = 15) compared with medical nutritional therapy alone (n = 15) (P < 0.01). A good predictive accuracy of SHBG was found for GDM requiring insulin therapy (area under the curve: 0.866, 95% confidence interval: 0.773-0.959). An SHBG threshold for 97.47 nmol/L had a sensitivity of 80.0%, specificity 84.6%, positive predictive value 50.0% and negative predictive value 95.7%. The calculated odds ratio for SHBG < 97.47 nmol/L was 12.346 (95% confidence interval: 1.786-83.33). Conclusions:  SHBG is valuable for screening women early in pregnancy for GDM risk; however, a standard assay for analyses and a threshold level of serum SHBG for a constant gestational week has to be determined.

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    ABSTRACT: Abstract Objective: To study various biomarkers in prediction of gestational diabetes mellitus (GDM). Patients and methods: Prospective observational study included 400 pregnant women. Maternal serum sex hormone binding globulin (SHBG), high-sensitive C-reactive protein (hs-CRP), uric acid, creatinine and albumin were measured before 15 weeks of gestation. Patients were followed up for development of GDM. Results: A total of 269 women were eligible for analysis. GDM complicated 27 (10.03%) of pregnancies. Hs-CRP levels were significantly higher and SHBG levels were significantly lower among women who subsequently developed GDM compared with normoglycemics. Uric acid, albumin and creatinine levels were not significantly different between both groups. For prediction of GDM, hs-CRP at a cutoff value of 2.55 mg/L showed a sensitivity and a specificity of 89% and 55% respectively. SHBG at a cutoff value of 211.5 nmol/L showed a sensitivity and a specificity of 85% and 37% respectively. Low SHBG with high hs-CRP predicted GDM with a sensitivity and specificity of 74.07% and 75.62% respectively with an overall accuracy of 75.46%. Conclusion: Hs-CRP and SHBG are important early predictors of GDM. Adding SHBG to hs-CRP improves specificity and serves good overall accuracy. Uric acid, creatinine and albumin have no role in GDM prediction.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 10/2013; · 1.36 Impact Factor

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