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Eur J Clin Invest. 2015 Oct;45(10):1025-31. doi: 10.1111/eci.12500. Epub 2015 Aug 24.

Maternal serum osteocalcin at 11-14 weeks of gestation in gestational diabetes mellitus.

Author information

1
Fetal Medicine Unit, Embryocare, Athens, Greece.
2
Fetal Medicine Unit, Emvryomitriki, Athens, Greece.
3
1st Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.
4
Department of Ultrasound and Fetal Medicine, Bioiatriki SA, Athens, Greece.
5
1st Department of Obstetrics and Gynecology, University of Athens Medical School, Alexandra Hospital, Athens, Greece.
6
2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece.
7
Hormone Laboratory, Bioiatriki SA, Athens, Greece.
8
Childhood Obesity Clinic, 1st Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece.
9
2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract

BACKGROUND:

Recent studies support that osteocalcin (OC), apart from its skeletal role, is implicated in glucose homoeostasis. Aims of this study were to examine the first-trimester maternal serum concentrations of OC in pregnancies that developed gestational diabetes mellitus (GDM) and to create a first-trimester prediction model for GDM.

DESIGN:

Case-control study in a prospective cohort of pregnant women. Maternal serum levels of OC were measured in 40 cases that developed GDM and 94 unaffected controls. First-trimester biophysical parameters, biochemical indices, maternal-pregnancy characteristics, and OC concentrations were assessed in relation to GDM occurrence.

RESULTS:

In the GDM group, first-trimester OC serum levels were increased compared to the control group (mean = 8·81 ng/mL, SD = 2·59 vs. mean = 7·34 ng/ml, SD = 3·04, P = 0·0058). Osteocalcin was independent of first-trimester biophysical and biochemical indices. Osteocalcin alone (OR = 1·21, CI: 1·02-1·43, P = 0·023) was a significant predictor of GDM [Model R(2) = 0·04, area under the curve (AUC) = 0·61, CI: 0·55-0·72, P < 0·001]. The combination of maternal and pregnancy characteristics with OC resulted in an improved prediction model for GDM (Model R(2) = 0·21, AUC = 0·80, CI: 0·71-0·88, P < 0·001). The combined model yields a sensitivity of 72·2% for 25% false-positive rate.

CONCLUSIONS:

First-trimester maternal serum levels of OC are increased in GDM pregnancies. Osteocalcin combined with maternal and pregnancy characteristics provides an effective screening for GDM at 11-14 weeks.

KEYWORDS:

First-trimester assessment; gestational diabetes mellitus; osteocalcin; prediction model

PMID:
26301628
DOI:
10.1111/eci.12500
[Indexed for MEDLINE]

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