Study on the correlation and predictive value of serum pregnancy-associated plasma protein A, triglyceride and serum 25-hydroxyvitamin D levels with gestational diabetes mellitus

Zhuo Ren; Dong Zhe; Zhi Li; Xin-Ping Sun; Kai Yang; Li Lin

doi:10.12998/wjcc.v8.i5.864

Study on the correlation and predictive value of serum pregnancy-associated plasma protein A, triglyceride and serum 25-hydroxyvitamin D levels with gestational diabetes mellitus

World J Clin Cases. 2020 Mar 6;8(5):864-873. doi: 10.12998/wjcc.v8.i5.864.

Authors

Zhuo Ren¹, Dong Zhe¹, Zhi Li¹, Xin-Ping Sun², Kai Yang¹, Li Lin³

Affiliations

¹ Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing 102206, China.
² Department of Clinical Laboratory, Peking University International Hospital, Beijing 102206, China.
³ Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing 102206, China. lingdanhu4@163.com.

Abstract

Background: Gestational diabetes mellitus (GDM) is a concern due to its rapid increase in incidence in recent years.

Aim: To investigate the correlation and predictive value of serum pregnancy-associated plasma protein A (PAPP-A), triglyceride (TG), and 25-hydroxyvitamin D [25-(OH)D] with GDM in early pregnancy.

Methods: A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included, and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy. Of these cases with GDM, 51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B. Serum PAPP-A, TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed. In addition, their diagnostic value in GDM was determined using receiver operating characteristic (ROC) curve analysis.

Results: Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B, with statistical significance (P < 0.05). Furthermore, Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose (FBG) levels (r = -0.605, P < 0.001), (r = -0.597, P < 0.001), while TG and FBG levels were positively correlated (r = 0.628, P < 0.001). The sensitivity, specificity, area under the curve (AUC) and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%, 82.35%, 0.861 and 16.340, respectively, while the sensitivity of TG in diagnosing GDM was 86.27%, the specificity was 66.67%, the AUC was 0.813, with an optimal cut-off value of 1.796. The corresponding sensitivity, specificity, AUC and optimal cut-off value of serum 25-(OH)D were 64.71%, 70.59%, 0.721 and 23.140, respectively. Moreover, multivariate logistic regression analysis revealed that FBG, vascular endothelial growth factor, Flt-1, serum PAPP-A, TG, and 25-(OH)D were related risk factors leading to GDM in patients.

Conclusion: Serum PAPP-A, TG, and 25-(OH)D levels are all correlated with blood glucose changes in GDM, and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.

Keywords: Early pregnancy; Gestational diabetes mellitus; Oral glucose tolerance test; Serum 25-hydroxyvitamin D; Serum pregnancy-associated plasma protein A level; Triglyceride.