Estimated Glycated albumin' levels early in pregnancy could detect women at risk to develop gestational diabetes mellitus

Background: Gestational diabetes mellitus (GDM) is characterized by dysfunction in maintaining glucose homeostasis leading to adverse maternofetal outcomes and this necessitates the use of markers for its early prediction. Objectives: To determine the ability of the estimated percentage of glycosylated hemoglobin (HbA1c%) and glycated albumin (GA%) at the 6th gestational week (GW) to define women liable to develop GDM. Patients and methods: 402 women were clinically evaluated and gave blood samples for estimation of fasting blood glucose (FBG) and HbA1c% and GA% at the 6th-8th GW. At the 24th GW, all women underwent the evaluation of insulin resistance (IR) using the Homeostasis model assessment of IR score and the 75-Oral Glucose Tolerance Test (75-OGTT) to diagnose GDM. The levels of estimated variate at the 6th-8th GW were statistically analyzed to define the predictor for GDM. Results: 62 women developed IR and 36 of them progressed to GDM. Statistical analyses defined FBG, GA%, HbA1c% as predictors for IR and GDM, but the Paired-sample area difference under the ROC curves defined high GA% as the significant positive predictor for GDM. Kaplan-Meier analysis defined GA% at 14% and 15% could define the risk for GDM by 20% and 40%, respectively but the evaluated performance characters at 15% were significantly (P=0.0074) higher than at 14 %. Conclusion: Estimation of GA% in blood samples obtained at the 6th-8th GW could predict the oncoming GDM with high specificity and negative predictive value at the cutoff of 15%