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New biomarker may predict gestational diabetes after failed glucose challenge test
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Levels of the plasma glycated protein CD59 may help identify which women will develop gestational diabetes and those at risk for large for gestational age newborns, according to findings published in Diabetes Care.
“In diabetes, nonenzymatic glycation inactivates the complement inhibitor CD59, forming glycated CD59 (GCD59),” the researchers wrote. “Using a sensitive and specific [enzyme-linked immunosorbent assay] for GCD59 in blood, we have shown that plasma GCD59 levels are significantly higher in individuals with type 2 diabetes and independently predict the response to the [oral glucose tolerance test].”
Jose A. Halperin, MD, of the division of hematology of Brigham and Women’s Hospital, and colleagues conducted a case-control study of 1,000 plasma samples from women receiving standard prenatal care to determine whether plasma GCD59 can predict the results of a glucose challenge test for screening for gestational diabetes. Researchers also sought to determine the diagnosis of gestational diabetes and the prevalence of large for gestational age newborns.
Control participants (n = 500) were identified as those with a normal response to a glucose challenge test. Case participants (n = 500) had an impaired response to the glucose challenge test and then underwent a 100-g, 3-hour OGTT. The sample collection took place at the same pregnancy time for both groups (26.5 weeks for controls; 26 weeks for cases).
Overall, 127 women in the cases met criteria for gestational diabetes after the 3-hour OGTT. Compared with the control group, median plasma GCD59 levels were 8.5-fold higher in cases and 10-fold higher in the 127 cases diagnosed with gestational diabetes.
The likelihood of having an impaired result to a glucose challenge test was eightfold higher in participants with plasma GCD59 levels in at least the 6th decile compared with those with plasma GCD59 levels below the 6th decile. The prevalence of babies born large for gestational age was associated with higher maternal plasma GCD59 levels; the prevalence was 4.3% in those in the lowest quartile of plasma GCD59 compared with 13.5% in the highest quartile of plasma GCD59 (P < .0001).
“This is the first study to demonstrate that a single measurement of plasma GCD59 can be used as a simplified method to identify women who would have failed a [glucose challenge test] and are at higher risk of [gestational diabetes],” Halperin said in a press release. “These results indicate that measurement of this novel disease-associated biomarker may be a convenient and effective alternative to the cumbersome methods currently used to screen and diagnose [gestational diabetes]; the study opens the door to future multicenter studies to confirm the clinical utility of plasma GCD59 as a biomarker for detection and diagnosis of [gestational diabetes].” – by Amber Cox
Disclosure: Halperin reports financial ties with Mellitus LLC. Please see the full study for a list of all other authors’ relevant financial disclosures.
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