Case Control Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2020; 8(5): 864-873
Published online Mar 6, 2020. 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
Zhuo Ren, Dong Zhe, Zhi Li, Xin-Ping Sun, Kai Yang, Li Lin
Zhuo Ren, Dong Zhe, Zhi Li, Kai Yang, Li Lin, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing 102206, China
Xin-Ping Sun, Department of Clinical Laboratory, Peking University International Hospital, Beijing 102206, China
Author contributions: Ren Z and Dong Z designed the research; Li Z performed the research; Sun XP analyzed the data; Yang K and Li L wrote the paper. Ren Z and Dong Z contributed equally to this work.
Institutional review board statement: This study was reviewed and approved by the Peking University International Hospital Ethics Committee.
Informed consent statement: All patients in our study provided informed consent.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Li Lin, PhD, Chief Physician, Department of Obstetrics and Gynecology, Peking University International Hospital, No. 1, Life Garden Road, Zhongguancun Life Park, Changping District, Beijing 102206, China. lingdanhu4@163.com
Received: November 26, 2019
Peer-review started: November 26, 2019
First decision: December 30, 2019
Revised: January 6, 2020
Accepted: February 10, 2020
Article in press: February 10, 2020
Published online: March 6, 2020
Processing time: 101 Days and 1 Hours
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; Serum pregnancy-associated plasma protein A level; Triglyceride; Serum 25-hydroxyvitamin D; Gestational diabetes mellitus; Oral glucose tolerance test

Core tip: In the present study, the serum levels of pregnancy-associated plasma protein A, triglyceride, and 25-hydroxyvitamin D levels in early pregnancy were evaluated. The results showed that these three parameters are potential influencing factors and can provide a certain predictive value for the occurrence of gestational diabetes mellitus. These factors have high value in clinical application.