Oral Presentation Society of Obstetric Medicine of Australia and New Zealand and Australasian Diabetes in Pregnancy Society Joint Scientific Meeting 2017

Biomarkers and GDM risk prediction  (#45)

Vidura Perera 1 , David Simmons 2 , Helena Teede 1 , Eldho Eldho Paul 3
  1. Medicine, Monash University, Melbourne, VIC, Australia
  2. Medicine, Western Sydney University, Sydney, NSW, Australia
  3. Public Health and Preventative Medicine , Monash University, Clayton, Victoria, Australia

Background and aim: Gestational diabetes (GDM) presents a major health and financial burden in terms of screening, treatment and complications. We aimed to explore cross sectional relationships between serum biomarkers and glucose levels at hospital booking <20 weeks (T1) and at 24-28 weeks gestation (T2).

Methods: This is a cross-sectional, prospective sub-study of the TOBOGM pilot study, recruiting women from hospital clinics at Campbelltown public hospital, with high risk of GDM at the booking antenatal visit (<20 weeks gestation). Participants had an oral glucose tolerance test (new ADIPS GDM criteria), with fasted serum samples (for fasting C-peptide, insulin, glucose, triglycerides, adiponectin, leptin and 3-betahydroxybutyrate) collected at <20 weeks gestation (T1) and 24-28 weeks gestation (T2). Women randomised for treatment for their ‘Booking’ GDM at T1, did not have blood tests at T2. Univariate cross sectional analyses were performed using Stata.

Results: Data from 79 women were available for this sub study. Mean age was 28.3±5.4 years and BMI was 30.3±7.3 kg/m2. At T1 and T2 there were 21/79 (26.6%) and 21/69 (30.4%) women with GDM respectively.  Insulin (OR=1.016, p=0.001), C-peptide (OR=1.003, p=0.001), 3-betahydroxybutyrate (OR=1.013, p=0.008), leptin (OR=1.025, p=0.015) and adiponectin (OR=0.878, p=0.029) were related to GDM status at T1 via logistic regression analysis. At T2, insulin (OR=1.007, p=0.038), C-peptide (OR=1.002, p=0.016), 3-betahydroxybutyrate (OR=1.015, p=0.036), and triglycerides (OR=2.48, p=0.029) were associated with increased risk of GDM. Adiponectin and leptin were no longer associated with GDM status at T2. No other tested biomarkers reached statistical significance.

Conclusion: This pilot sub-study suggests that insulin resistance and 3-betahydroxybutyrate are related to GDM status at both hospital booking and at 24-28 weeks. Inflammation is related to GDM at booking. Further studies are needed to establish drivers of glucose status in pregnancy and to explore predictors of GDM development.