First Trimester Serum Uric Acid as an Early predictor of GDM

• Hema Sharanagouda Patil,  
• Aritri Bhattacharya*

Abstract

Background: Gestational Diabetes Mellitus (GDM) is a condition of impaired carbohydrate tolerance first recognized during pregnancy, typically diagnosed between 24-28 weeks. South Asian, particularly Indian, females are at an eleven-fold higher risk compared to European females. GDM increases the likelihood of operative vaginal deliveries, cesarean sections, and complications like shoulder dystocia and macrosomia. Screening methods for GDM include historical data, clinical examinations, and tests like DIPSI and OGTT. Early detection and prevention are limited, though new biomarkers such as BNP, Afamin, FGF21, ANGPTL8, and others have been identified. However, implementing these biomarkers in practice is challenging due to cost and availability issues. Acost-effective, and reliable early marker for predicting GDM is needed. Research has shown that the inflammatory state of the body can lead to end products of metabolism that harm endothelial function in skeletal muscles, causing peripheral resistance and diabetes. Serum Uric Acid, a common byproduct of metabolism, has been linked to this pathophysiology and GDM Methods: This study assessed the utility of serum uric acid levels in the first trimester to predict GDM among low-risk pregnant women. Serum uric acid levels were measured from first-trimester blood samples, and DIPSI testing was performed at 24-28 weeks and 28-32 weeks. Logistic regression and Receiver Operating Characteristic curves evaluated the predictive ability of serum uric acid for GDM. Cut-off values were determined using the Youden index, with a significance level of p ≤ 0.05. Results: A total of 106 patients participated. The AU-ROC for serum uric acid was 0.8316, with a cut-off > 3.4 showing 74.70% sensitivity and 82.61% specificity for predicting GDM. Logistic regression indicated that serum uric acid significantly predicted GDM (p < 0> 3.4 showing 14.02 times higher odds of developing GDM (95% CI: 4.28 - 45.92). Conclusion: Serum uric acid levels in the first trimester can effectively predict the development of GDM.

Keywords

GDM, Uric Acid, DIPSI, OGTT