FIRST-TRIMESTER SERUM URIC ACID CONCENTRATIONS AS A PREDICTOR FOR GESTATIONAL DIABETES MELLITUS

Document Type : Original Article

Author

Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Suez General Hospital

Abstract

Objective: To evaluate first trimester serum uric acid level as a predictor
for gestational diabetes mellitus.
Patients and method:A prospective observational study at obstetrics and
Gynecology Department of Suez Canal University Hospital during the period from March 2011 to March 2012. A total of 850 pregnant women with
gestational age 10 – 13 weeks at presentation were recruited into the study.
All women were subjected to complete history, full general and obstetric examination and routine obstetric ultrasonography evaluation. Serum
uric acid was measured at time of presentation screening for diabetes was
done at 24 - 28 weeks of gestation using 50gm oral glucose-loading test
if >140mg/dl, subsequent 3hrs oral 100g glucose tolerance test (OGTT)
was done, diagnosis of GDM was done when at least two of the following
plasma glucose values was high.
Results:A total of 37 /813women were diagnosed to have GDM. Women
with GDM have higher mean BMI (29.02 kg/m2) than women without
GDM (26.04 kg/m2) with p-value < 0.05. Median serum uric acid at 10 -
13 weeks of gestation was significantly higher among women with GDM
(3.5 mg/dl versus 2.9 mg/dl among women without GDM, p-value < 0.05).
The adjusted odds of gestational diabetes increased with increasing first
trimester uric acid quartile (p=0.003 for trend). ROC curve showed that
best cutoff value was set at ≥ 3.05mg/dl with 75.7% sensitivity, 57.8%
specificity, 7.5% positive predictive value and 89.1% negative predictive
value. Risk estimate showed increased risk of GDM with serum uric acid
≥ 3.05 mg/dl with risk ratio =4.02.
Conclusion: first trimester serum uric acid concentration is a significant
predictor for development of GDM.

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