Journal of diabetes investigation 2017 04 07() doi 10.1111/jdi.12672
To investigate the relationship between pregnancy-associated plasma protein A (PAPP-A) and gestational diabetes mellitus (GDM) and to determine whether PAPP-A has improved value for predicting GDM in a Chinese population.
Clinical data for 599 GDM patients and 986 unaffected pregnant women undergoing both antenatal examinations and delivery were retrospectively analyzed. First-trimester serum PAPP-A levels were compared between the groups. Binary logistic regression analysis was used to explore the risk factors for GDM, and the area under the receiver operating characteristic (AUC-ROC) curve was used to determine the value of PAPP-A for predicting GDM.
GDM-affected and unaffected pregnant women were significantly different in terms of age (P<0.001), BMI (P<0.001), family history of diabetes (P=0.002), α-thalassemia trait (P<0.01), parity (P<0.001), conception methods (P<0.001), gestational weeks at the time of labor (P<0.001) and corrected PAPP-A multiples of the median (MoMs) values (P<0.001). Binary logistic regression analysis revealed that PAPP-A levels were negatively related to the subsequent development of GDM (OR 0.798; 95%CI: 0.647-0.984). The AUC-ROC for maternal factors was 0.684 (95%CI: 0.657-0.711) and did not significantly differ from that for the combination of maternal factors and serum PAPP-A levels, which was 0.686 (95%CI: 0.660-0.713) (χ(2) =0.625, P=0.429). CONCLUSION
Serum PAPP-A was an independent factor for the development of GDM in pregnant Chinese women. Serum-PAPP-A does not have improved value with respect to predicting GDM when combined with other maternal factors. This article is protected by copyright. All rights reserved.