Risk estimation of gestational diabetes mellitus in the first trimester

There is no early - first trimester- risk estimation available to predict later (gestational week 24-28) gestational diabetes mellitus (GDM) - however it would be beneficial to start an early treatment to prevent the development of complications.We aimed to identify early, first trimester prediction markers for GDM.The present case-control study is based on the study cohort of a Hungarian biobank containing the biological samples and follow-up data from 2545 pregnant women. Oxidative-nitrative stress-related parameters, steroid hormone, and metabolite levels were measured in the serum/plasma samples collected at the end of the first trimester from 55-55 randomly selected control and later GDM women.Pregnant women, who developed GDM later during the pregnancy were older and had higher body mass indexes (BMI). The following parameters showed higher concentration in their serum/plasma samples: fructosamine, total antioxidant capacity (TAC), testosterone, cortisone, 21-deoxycortisol; while soluble urokinase plasminogen activator receptor (SuPAR), dehydroepiandrosterone sulfate (DHEAS), dihydrotestosterone (DHT), cortisol and 11-deoxycorticosterone levels were lower. Analyzing these variables using a forward stepwise multivariate logistic regression model we established a GDM prediction model with a specificity of 96.6% and sensitivity of 97.5% (included variables: fructosamine, cortisol, cortisone, 11-deoxycorticosterone, SuPAR).Based on these measurements we accurately predict the development of later onset GDM (24th-28th weeks of pregnancy). Early risk estimation provides the opportunity for targeted prevention and the timely treatment of GDM. Prevention and slowing the progression of GDM result in a lower lifelong metabolic risk for both mother and offspring.