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Potential marker for gestational diabetes identified
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Low concentrations of sex hormone-binding globulin prior to pregnancy were associated with an increased risk for gestational diabetes and may be a useful marker in identifying those at risk for the condition.
Along with high levels of testosterone, low levels of SHBG are associated with incident type 2 diabetes in women. Using a nested case-control study design, researchers sought to determine whether low concentrations of SHBG were associated with a greater risk for gestational diabetes. To do so, researchers gathered information on serum SHGB in 4,098 women without diabetes who participated in the Kaiser Permanente Northern California multiphasic health checkup from 1984 to 1996 and became pregnant between 1984 and 2009.
At the time of the checkup, each participant provided one additional serum sample for later use, serum glucose amounts and BMI were measured, and additional data were collected regarding age, sex, race and ethnicity, family history of diabetes, medical history, level of education, tobacco use, alcohol and caffeine consumption, use of medication and other factors. Women with diabetes before pregnancy were excluded from the study.
For each participant who developed gestational diabetes (n=256), researchers matched two control patients based on year of blood draw, age at exam and pregnancy and number of intervening pregnancies.
After adjusting for family history of diabetes, BMI before pregnancy, race/ethnicity, alcohol use, weight changes before pregnancy and homeostasis model assessment of insulin resistance (HOMA-IR), the risk for gestational diabetes was four times higher among women in the lowest quartile of SHBG levels (8 nmol/L-44.2 nmol/L; OR=1.06; 95% CI, 0.44-2.52) compared with those in the highest quartile (OR=1.06; 95% CI, 0.44-2.52). Researchers reported a negative correlation between SHBG levels and age, BMI and HOMA-IR in both case and control patients. Additionally, the risk for gestational diabetes was five times higher among women with BMI ≥25 and SHBG levels below the median (<64.5 nmol/L) vs. those of normal weight and SHBG levels at or above the median (OR=5.34; 95% CI, 3-9.49), according to researchers.
Disclosure: The researchers reported no relevant financial disclosures.
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