First trimester sex hormone-binding globulin predicts gestational diabetes mellitus in a population of Nigerian women

There has been a steady rise in the disease burden of Gestational Diabetes Mellitus (GDM) in the sub-Saharan African region over time. Diagnostic testing for GDM is currently recommended at 24 − 28 weeks of gestation, leaving a narrow window for intervention before delivery. Hence the need for early prediction and preventive intervention. The performance of first trimester serum sex hormone-binding globulin (SHBG) assay as a predictor of GDM was determined by binary logistic regression. Women with GDM (n = 49) had a significantly lower mean first trimester SHBG level (104.7 ± 61.6 nmol/L) than did those without GDM (n = 180; 265.2 ± 141.5 nmol/L; p < .001). First trimester SHBG was significantly negatively correlated (rpb = −0.460, p value = <.001) with subsequent development of GDM and an area under receiver operator characteristics (ROC) curve of 0.874 (p < .001). A cut-off value of 158.0 nmol/L predictive of GDM had a diagnostic sensitivity of 81.5%, a specificity of 80.1%, and an overall diagnostic efficiency of 80.3%.IMPACT STATEMENT What is already known on this subject? GDM is associated with high risk of various complications and is commonly diagnosed at 24–28 weeks of gestation, leaving a narrow window for intervention. The performance of current maternal clinical and demographic risk factor-based prediction approaches is unreliable. Thus, more favourable prediction approaches need to be developed. Previous studies have suggested that SHBG, a readily assessable marker, has potential to predict GDM; however, these studies have mostly involved Caucasian and other non-African populations. What the results of this study add? SHBG may serve as a reliable first trimester screening tool for GDM development in Nigerian women with singleton pregnancies. This study demonstrates that first trimester SHBG can predict GDM development in sub-Saharan African women despite racial, ethnic and geographical differences. What are the implications of these findings for clinical practice and/or further research? Effective first trimester prediction of GDM using SHBG may enable preventive interventions, thereby mitigating the high burden of the disease in the sub-Saharan African region. It may also provide relevant information that may guide adaptation of current management guidelines to ensure effective management of GDM in the region

Levels of Salivary Immunoglobulin A and Immunoglobulin G in Type 2 Diabetic Patients

Background: Diabetes mellitus is a chronic disorder of glucose metabolism and it is associated with a compromised oral immunity. Salivary immunoglobulins offer a comprehensive protection for the oral cavity; however, there is insufficient data regarding their levels in type 2 diabetic patients. This study aimed to measure salivary Immunoglobulin G (IgG) and Immunoglobulin A (IgA) in diabetic patients in comparison to healthy nondiabetic controls. Methods: Diabetic patients from the outpatient clinic and nondiabetic healthy members of staff, were recruited for this study. Unstimulated saliva samples were collected from all participants and levels of immunoglobulins A and G were determined using enzyme-linked immunosorbent assay techniques; the values were compared between the two groups. Results: A total of 167 participants were recruited for this study, 95 (56.9%) of them were diabetic patients, while the remaining 72 (43.1%) were healthy nondiabetic controls. The median salivary IgA was 12.57 (Interquartile range [IQR] 11.05–13.67) g/ml in the diabetics and 11.94 (IQR 10.41–13.65) µg/ml in the control group; P = 0.31 while the median salivary IgG was 32.27 (IQR 25.26–38.33) µg/ml in the diabetics and 26.26 (22.48–31.29) µg/ml in the control group; P &lt; 0.001. Conclusion: Salivary IgG was significantly elevated in the diabetic patients, in spite of a higher prevalence of oral infections, this calls for a more stringent attention to oral hygiene in diabetic patients